FACILITY SIGN UPFacility InformationFacility Name*Please provide accurate facility name to avoid confusionList the services provided at your facility.*The data collected helps us for our analytics and reporting.Assisted LivingMemory CareNursing HomeAdult Day CareIndependent LivingRetirement CommunityHospitalRehab CenterHospice CareRespite CareSchool For Blind ChildrenChild Care(Day Care)Special Needs schoolOtherIf Other, please specify services provided at your facility.*Facility Address Line 1*Facility Address Line 2Facility Country*Work is in progress to open the program in our countries very soon. Stay tuned.AfghanistanÅland IslandsAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBolivia, Plurinational State ofBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos (Keeling) IslandsColombiaComorosCongoCongo, the Democratic Republic of theCook IslandsCosta RicaCôte d'IvoireCroatiaCubaCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFalkland Islands (Malvinas)Faroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly See (Vatican City State)HondurasHong KongHungaryIcelandIndiaIndonesiaIran, Islamic Republic ofIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyan Arab JamahiriyaLiechtensteinLithuaniaLuxembourgMacaoMacedonia, the former Yugoslav Republic ofMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesia, Federated States ofMoldova, Republic ofMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNetherlands AntillesNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorthern Mariana IslandsNorwayOmanPakistanPalauPalestinePanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRéunionRomaniaRussian FederationRwandaSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint Martin (French part)Saint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwazilandSwedenSwitzerlandSyrian Arab RepublicTaiwan, Province of ChinaTajikistanTanzania, United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUnited States Minor Outlying IslandsUruguayUzbekistanVanuatuVenezuela, Bolivarian Republic ofViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweFacility State*Work is in progress to open the program in our states very soon. Stay tuned.AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingFacility City*Facility Zip*Facility County*Primary Contact InformationFirst Name*Last Name*Email*Confirm Email*Mobile*Title*Specify your role at the facilityActivity AssistantActivity ManagerActivity DirectorFacility AdministrationRecreation CoordinatorVolunteer CoordinatorOtherOther InformationBriefly describe your facility's volunteering needs*Example. Facility will prefer volunteers to visit cafeteria during meal times, also volunteers can visit memory care unit during meal timeHow did you hear about us?*Friend & FamilySchoolSocial Media (Facebook, Twitter, Instagram)Radio, Newspaper or TelevisionInternet SearchWePlayMusic4You ResourceOtherPlease specify name of the WePlayMusic4You resource.*If other, specify.*Facility Photo Consent*By providing consent, you are indicating that the visiting student volunteers can record their performance at the facility. NOTE: Respecting each facility resident's consent choice for photos, each student volunteer is required to seek facility's permission each time before taking photos and videos.YesNoFacility consent to use facility name on our website*By providing consent, you are permitting WePlayMusic4You to mention your facility name on the WePlayMusic4You website. YesNoFacility Website URL (Optional)Please provide your facility's website URL if applicableUpload Facility Image (Optional)Facility photo will help the student volunteer to be familiar with your facility before the visit Upload Upload Facility Image (Optional)UploadFacility has piano?*YesNoShare piano location. Example: Lobby*Login InformationUsername*Password*At least 8 characters with at least 1 letter and number, and at least 1 uppercase and 1 lowercase letterConfirm Password*E-mail Address*Please provide accurate email address to receive account sign up communicationBy clicking 'Submit' below, you are indicating your acceptance with the Terms and Conditions for this site. Click Here to view the Terms And Conditions. Only fill in if you are not human
