Application Form
Mousetrap Theatre Projects enables young people with limited resources, access or support to engage with the best of London’s theatre.
Envision has an allocation of 50 tickets at each performance. We will prioritise new participants to the programme. Please do not apply for tickets you cannot use as we are unable to offer refunds on any unused tickets. Please return this form by post or fax to 020 7632 4111. Contact name:
We offer innovative theatre access, education and audience development programmes to stimulate and inspire young people. At the heart of our work is the desire to open doors to young people who might otherwise consider London’s rich cultural heritage closed to them.
Job title/relationship to young person(s) attending: School name: (if applicable) LEA:
Email:
Address:
Postcode:
Tel:
Fax:
VocalEyes is a nationwide audio description service providing access to the best in the arts for blind and partially sighted people, not only in theatre but also museums, galleries and heritage sites. For details see www.vocaleyes.co.uk
Mobile: Please state the best time of day to reach you: Age(s) of young people attending: How did you hear about Envision? Access requirements
Mousetrap Theatre Projects 23-24 Henrietta Street Covent Garden, London WC2E 8ND T: 020 7632 4117 F: 020 7632 4111 E: jo@mousetrap.org.uk www.mousetrap.org.uk
Please specify the range of visual ability within the group: Please describe any other special needs or requirements (e.g. hearing impairment, other disability): Do you require wheelchair spaces?
Yes/No
If so, how many?
(Please refer to the show descriptions for the spaces available)
We are most grateful to the following funder: VICTA Children
Registered Charity no. 1053434
✂
Can any of the wheelchair users transfer into seats? Yes/No If so, how many? Ticket requirements. Please number your choices as #1, #2, etc. ___ 4 November
The Railway Children
___ young people
___adults
Total: ___
___11 November
The Railway Children
___ young people
___adults
Total: ___
___ 10 February
Legally Blonde
___ young people
___adults
Total: ___
___ 17 February
Legally Blonde
___ young people
___adults
Total: ___
Envision 2010 – 2011
An unforgettable theatre day for young people with visual impairment In partnership with VocalEyes
If you have any queries about completing this form, or Envision in general, please contact Jo Pelly on 020 7632 4117 or jo@mousetrap.org.uk
...inspiring young people
...inspiring young people