Service User enquiry| Lost Chord UK Interactive Music Session

Your contact details will be safely stored in accordance with GDPR

Our Mission“Is to make the transformative power of live music accessible to everyone facing dementia or neurological conditions and their carers, to improve their health and wellbeing, so that no one feels alone."

Thank you for your enquiry and for taking the time to complete our enquiry form. At Lost Chord UK, our interactive music sessions are in high demand and meticulously coordinated to ensure the best possible experience for our service partners. This involves considering various factors such as key service locations, our operations' scheduling, and our professional musicians' availability. We also prioritise and honour commitments for our current cohort of highly subsidised charitable services. You can find more about the magic of our musicians and supporting volunteers and what makes our sessions so special on our website. Rest assured, we will do our utmost to accommodate your needs and provide a memorable and positively impactful interactive music session for all involved. Thank you for your support.

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* 1. What is your orginansation's name

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* 2. Please give the full contact details of your organisation

Address *

Address 2

City/Town *

County

Post Code *

Name of Manager/Key contact *

Email Address of Manager/Key contact *

Telephone Number *

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* 3. If you are enquiring about our subsidised Sessions are you able to contribute towards the cost? For subsidised sessions, we request a minimum contribution of
£80 for a solo high- quality LCUK musician interactive session,
£130 for a Choir /Community Session leader
£150 towards a duo musician session (ie. two LCUK musicians)
Kindly note that the different sessions above typically cost Lost Chord UK between £200 and £300 to deliver and are subsidised where possible by charity fundraising efforts and public donations.

There is more on our website about the different roles we offer and how our unique music services from our professional musicians and supporting volunteers can benefit people in your community.
Additional details and quotes regarding half, one day or bespoke events can also be provided upon request.
Please confirm below if you are able to meet the minimum contribution? and if so, how much more? you are able to provide (per concert session) towards reducing drawing on our charitable subsidies, to match your session choice and needs. Each contribution you make enables us to reduce the cost and importantly maximise our reach to support more people from public donations. Kindly note LCUK can provide fundraising support and guidance to help you.

Yes

If yes, please explain which sessions you are interested in ie. duo, solo etc and how much you would be able to contribute towards session(s).

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* 4. Please tell us in a few lines about your residents/ community/venue needs e.g. what kind of service you're looking for | e.g. ad- hoc, monthly quarterly sessions, request a particular LCUK musicians to attend or music? number of participants etc?

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* 5. Please tell us how you found out about Lost Chord UK?

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* 6. Please provide the email address of the activities coordinator/primary contact?

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* 7. Do you consent for Lost Chord UK to store your data in accordance with our GDPR privacy policy available to read on our website? https://lost-chord.org.uk/privacy-policy/

Yes

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* 8. Please tick the days and times of the week that work best for you for a one hour Lost Chord interactive music session

Monday morning slot

Monday early afternoon

Monday later afternoon

Tuesday morning slot

Tuesday early afternoon

Tuesday later afternoon

Wednesday morning slot

Wednesday early afternoon

Wednesday later afternoon

Thursday morning slot

Thursday early afternoon

Thursday later afternoon

Friday morning slot

Friday early afternoon slot

Friday later afternoon slot

Saturday morning slot

Saturday early afternoon

Saturday later afternoon

Please specify if you have a best time and day(s)

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* 9. Do you have a piano we could use?

Yes

Not sure if it is in tune/works. We would like a Lost Chord UK pianist to check it out when they come

Other (please specify)

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* 10. Is there parking at your venue?

Yes

(please provide any additional details of times, charges and limitations.

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* 11. Do we need a Purchase Order Number to invoice you? If you answer yes you will be required to send the PO numbers direct to Lost Chord UK once the session(s) have been agreed.

Yes

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* 12. Please provide an email address where invoices should be sent. (Kindly note that Lost Chord UK invoices are sent via Xero). Please note that we and our musicians are unable to accept cash for sessions. Please pay where possible by BACS bank transfer as this incurs no surcharge.
Fees
Kindly note, payments made by cheque will incur an additional administration charge of £5. For payments processed through Stripe, GoCardless, or any other transaction medium, there may be an additional charge. Currently this fee typically ranges from 1.4% to 3% of the transaction amount, along with a fixed fee per transaction (e.g., £0.20 to £0.30). These charges cover the cost of processing payments securely and efficiently. Please contact us should you require a quote.

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* 13. Which email address would you like us to send the booking confirmation document to? (This will come via Docusign.)

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* 14. Would you like Lost Chord UK to email you a flyer to advertise and promote concerts to display in your home/venue?

Yes

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* 15. Please enter any other information that you think is relevant about your beneficiaries and service needs of our interactive music sessions.

Thank you for reaching out to us about scheduling an interactive music session. We appreciate your interest and will get back to you as soon as possible. Thank You.