Early Childhood Dance & Science – March 4, 2023

Name: *

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

Email: *

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?: 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? Enter N/A if not applicable.: *

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

Demographic info for grant purposes: How many children do you anticipate teaching this academic year? Enter N/A if not applicable.: *

Demographic info for grant purposes: How many of these children have special needs? Enter N/A if not applicable.: *