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Halifax Humanities Society
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Halifax Humanities 101 Application Form
Your Name
Your Email
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Phone Number
Are you interested in participating in Perspective 2020 (October-November 2020) or Halifax Humanities 101 (January – June 2021)?
Perspective 2020
Halifax Humanities 101
Both
Perspective 2020 will be held exclusively online, and Halifax Humanities 101 may include some online components, depending on provincial guidelines in January. Do you have access to:
?
A reliable computer or tablet that can connect to the internet
High-speed internet at home
Can you attend classes on Tuesdays and Thursdays from 1-3 pm?
Yes
No
Are you willing to read at least 5-10 hours a week in preparation for class?
Yes
No
Do you require bus tickets to attend class at Halifax North Library?
Yes
No
Do you require childcare in order to attend class?
Yes
No
What is your first language?
How did you learn about Halifax Humanities 101?
Do you have a health condition (mental or physical) that we should know about in order to make your participation in the program as comfortable as possible? If so, please briefly describe this condition and how it will impact your ability to attend classes in a public facility.
What is your source of income? (All of this information will be kept confidential)
What is the highest level of education you have completed? (Transcripts not required)
What would you hope to gain from your involvement with Halifax Humanities 101 &/or Perspective 2020?
Would you please provide the names and contact information of 2 people (social worker, health care professional, clergy person, educator) who could speak to us about your readiness to undertake this program.
In the space below, please write a few sentences about yourself, your interests, and why you would like to take this program.
How do you prefer to be contacted?
By Telephone
By Email
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