Dance in ECE Level 2

Name: *

Professional Title: Dance Teaching Artist Classroom Teacher Non-teaching Artist Administrator Student Other

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How did you hear about us?: Luna Website Friend Flyer Postcard send to you Email sent to you Child's school Community Calendar Display Ad Other

Demographic info for grant purposes: What are your teaching settings? Check all that apply.: studio public school private school charter school university/college community center ECE setting other N/A

Demographic info for grant purposes: If you teach in a public school, what district is it in?: *

Demographic info for grant purposes: What age(s) are your students?: 0-2 ECE 3-5 ECE 5-6 kindergarten 7-10 elementary 11-13 middle school 14-18 high school college/university adults seniors N/A

Demographic info for grant purposes: How many children do you anticipate teaching this academic year?: *

Demographic info for grant purposes: How many of these children have special needs?: *