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* 1. In what way are you intending to be involved in this project?

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* 2. Name (and name of centre requesting a catalogue)

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* 3. Email

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* 4. Location (include address if a centre requesting a catalogue)

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* 5. Type of artwork or creative interest (only if submitting work)

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* 6. I rely entirely on word of mouth. Please let me know of anyone at your centre who's artistic ability (painting, poetry, dance, art therapy, anything creative) might benefit or inspire others. Please take a minute to think about this as an extra minute of your time will save many hours of mine trying to find people. Do include email addresses or means of contact.

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