* 1. Are you interested in being on an email list to receive updates and information about the NDNU Art Therapy Doctoral Program?

* 2. Which of the following best describes you?

* 3. What degrees and registrations/certifications do you have? Please check all that apply.

* 4. In what state/country do you live?

* 5. For each of the following statements, please indicate your level of interest/endorsement.

  Very Low degree of interest Low degree of interest Medium degree of interest High degree of interest Very High degree of interest
I think it is a good idea that NDNU is developing a doctoral program in art therapy.
I have an interest in applying to attend the doctoral program in art therapy at NDNU.
The cohort model, with classes once a month, plus a summer intensive, is a model that would work well for me.
I would not be able to attend once a month, but would be interested in an alternate model.

* 6. List 1-3 reasons why you would like to get a Doctorate in Art Therapy

* 7. In what way would a Doctorate in Art Therapy benefit you or others?

* 8. Please rate your interest in the following topics within a doctoral program. Use "1" to indicate your HIGHEST interest, "2" for your next choice, etc.

  1 2 3 4 5
philosophical and theoretical underpinnings of art therapy
clinical
arts-based inquiry of self/others
education (teaching art therapy in higher education)
research

* 9. Please rate your interest in the following topics within art therapy. Use "1" to indicate your HIGHEST interest, "2" for your next choice, etc.

  1 2 3 4 5 6 7
clinical practice
research
work with specific populations
community engagement (art therapy as social change)
relationship of art therapy with the other creative arts modalities
spiritual dimension of art therapy
neuroscience

* 10. Additional Comments?

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