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* 1. Name

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* 2. Email

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* 3. Phone Number

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* 4. What would you hope to gain from the Teacher Training?

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* 5. If you selected Professional development, what populations do you / would you like to serve as a Dance from the Heart facilitator? 

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* 6. Have you taken a Dance from the Heart workshop or class with us before? If so, please describe.

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* 7. What is your prior experience with dance, movement, somatics, and/or other embodiment practices? (None is required to attend this Teacher Training)

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* 8. Are you available to attend all training sessions? Classes will be held online via Zoom. Please check all dates below:

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* 9. How did you hear about the Dance from the Heart Teacher Training?

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* 10. Would you like to apply for a scholarship to attend the training? Cost is $500.

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