Halifax Humanities 101 Application Form | Halifax Humanities Society

Halifax Humanities Society


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Halifax Humanities 101 Application Form Your Name Your Email Address City Province Phone Number Phone Number 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? 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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