APPLY Apply for our program First Name * Last Name * Street Address * City * State * Zip Code * Phone * Email * Emergency contact number * Emergency contact name * Are you covid-19 vaccinated? Yes No Have you been diagnosed with * PTSD Depression Instrument choice (choose 1) * Rhythm Guitar Lead Guitar Bass Guitar Favorite music style (select all you like) Rock Country Prog Rock Folk Bluegrass Jazz On a scale of 1 to 10 how does PTSD affect your daily life? * 1 2 3 4 5 6 7 8 9 10 On a scale of 1 to 10 how does depression affect your daily life? * 1 2 3 4 5 6 7 8 9 10 If approved for this program can you guarantee 30 minutes per day to practice? * Yes No Any physical limitations that may affect you in this program? What do you hope to gain from your participation in this program? Lesson Location preferences (select all you'd be willing to travel to) * Millsboro, DE Dover, DE Federalsburg, MD Salisbury, MD Lewes, DE If eventually offered would you prefer in-home lessons over visiting a site * Yes No If you are human, leave this field blank. Submit
Helping vets crush PTSD and end soldier suicideHelping vets crush PTSD and end soldier suicide