Rhythm Works Integrative Dance/Wingman Scholarship Application Question Title * 1. What is your full name? Question Title * 2. What is your phone number? Question Title * 3. What is your email address? Question Title * 4. What is your address? Street Address City State/Province Country Zip Code Question Title * 5. What is your profession? Dance Teacher Studio Owner Dance Department Director Occupational Therapist Physical Therapist ABA Therapist Speech and Language Pathologist Developmental Play Specialist Physical Education Teacher Special Education Teacher Other (please specify) Question Title * 6. How many years have you been active in your profession, and what are your specialties? Question Title * 7. Do you have any experience working with people with special needs or individual learning differences? If so, please let us know about it. Question Title * 8. If chosen to receive this scholarship, how to do intend to put the Rhythm Works Integrative Dance certification to use? Question Title * 9. Tell us about what makes you unique! What types of things do you love doing...what are your interests...how do you stand out from the crowd...have you received any awards or accolades...and anything else you'd like us to know about you! Question Title * 10. What do you hope to learn from the Rhythm Works Integrative Dance Instructor Certification Workshop? Submit!