Care Home Application Form Question Title * 1. Name and address of care home: Question Title * 2. Lead contact name: Question Title * 3. Lead contact email address: Question Title * 4. Lead contact telephone number: Question Title * 5. Number of residents: Question Title * 6. Why would you like to participate in this funded project? Question Title * 7. Would you be happy for your residents and staff to be filmed taking part in activities? Yes No Question Title * 8. Would you be happy to record your residents talking about a topic they are interested or their memories to share their experience and knowledge with children? Yes No Question Title * 9. Would you be happy to complete a simple case study evaluation at the end of the project? Yes No Question Title * 10. Do you have a large smart screen television with the ability to access wifi and internet services such as Zoom? Yes No Question Title * 11. Do you have ipads/android tablets with internet access (if yes how many)? Yes No Done
