Therapeutic Dance Certificate Application

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Name* This field is required.
First Name
Last Name
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When do you plan to start your courses?* This field is required.In the interest in cultivating community in the learning process, we create cohorts of students. Please indicate below when you would like to begin your study through EEIC.
Fall 2026
Fall 2027
Fall 2028
Fall 2029
Fall 2030
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4
Phone Number* This field is required.
Please enter a valid phone number.
5
E-mail* This field is required.By adding your email, you agree to receive marketing communications like newsletters, updates, promotions, special offers, or personalized content from EEIC, and signifying your consent to opt in to the ARDMT email list
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6
Please share why you are interested in studying therapeutic dance.* This field is required.
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Movement History* This field is required.Describe years of dance training and current movement practices. You may cut and paste a dance resume below.
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Please provide an emergency contactIn case of emergency, we would like to know who to contact on your behalf.
Name
Relationship
Email of Emergency Contact
Mobile Phone of Emergency Contact
9
While some coursework through EEIC is offered online, in person attendance in Chicago, IL is required for some coursework.Please note below any concerns or questions about in person attendance.
10
Education & ExperiencePlease indicate your degree and/or dance training
Degree
Dance Training
11
Upload a resume and/or educational transcript
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Max. file size: 10.6MB
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Letter of RecommentationPlease upload a letter of recommendation from a professional contact or professor in your clinical training program.
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Max. file size: 10.6MB
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Please provide a movement sample.Provide a video link (youtube, instagram link, vimeo or dropbox) that shares who you are through movement. Link can be private, but must be accessible for EEIC faculty to review.
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How did you hear about EEIC?
See Chicago Dance
ADTA Website
Web Search
Word of mouth
Other
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My Products* This field is required.A nonrefundable application fee is of $25.00 is due at the time of application and is used to cover contract administrative costs. The application process is not complete and a space will not be offered in a cohort until the application fee is paid.
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Therapeutic Dance Certificate Application FeePlease enter a shorA nonrefundable application fee is of $25.00 is due at the time of application and is used to cover contract administrative costs. The application process is not complete and a space will not be offered in a cohort until the application fee is paid.
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