CCTP INTEREST SURVEY

Travel Program Interest Survey
Please let us know what would make you feel fulfilled on this trip! Your responses will help the research program to be tailored to your personal needs. Feel free to call us if you come up with questions, ideas or suggestions.
Name

First NameLast Name
E-mail
Program Travel Date (Month/Year) & Group (if applicable)
What are the most important goals for your trip?
Based on the interests of the travelers, we can explore a variety of aspects of life in Cuba... Which of the following are you interested in exploring?

DanceMusicHealthEducationVisual ArtsEnvironmental SustainabilityOther
Other? Tell us more!
Would you like to dance?

YesNo
Great! How much?

Each dayMost daysA few daysOnce
Do you have previous dance experience?

Yes, professionalYes, someNo
Great! Which styles of dance do you have experience in?
Of these dance styles, which would you like to explore while in Cuba?

Afro-Cuban Dance &/or Drum (Yoruba/Congo)Franco-Haitian Afro Cuban Dance &/or DrumRumba Dance &/or DrumSon Dance &/or MusicCasino/Timba/Salsa Dance &/or MusicContemporary/Modern DanceHip Hop, Breakin, VideoNYC & LA Style SalsaBallroomSwingJazz
Do you have previous drumming experience?

YesNo
Do you have previous singing experience?

YesNo
Public Health: Interested in Learning More? Tell Us Below! If not, SKIP.
If so, What areas of public health are you most interested in researching in Cuba, otherwise SKIP

Arts a therapeutic toolAgriculture, food justice, & env't sustainabilityMaternal and child healthCuban health systemHIV/STIsCommunity program development
Please elaborate on your health interests in Cuba!
Education & Public Health: Interested in Learning More? Tell Us Below! If not, SKIP.
What areas of education & mental health are you most interested in researching on this trip, otherwise SKIP

Education for populations with special needsPedagogy and curriculum developmentArts educationCommunity program development
Please elaborate on your education interests in Cuba
Visual Arts: Interested in Learning More? Tell Us Below! If not, SKIP!
Are you interested in researching visual art while on this program?

YesNo
Great! Please elaborate.
Looking at the sample schedule, and/or drawing on other resources you may have more information, are there any site visits that you are really looking forward to?

Castellana Pyscho-Pedagogic CenterCommunity Dance ProjectsDance Company RehearsalMental Health CenterLa ColmenitaViaDanza / Danza ChevereOther
Other Interests? Tell Us More.
Do you want to teach? If so, please describe what you can teach and to whom. (Example: I can teach salsa On2 to any level, I can teach Hip Hop to kids, I would enjoy teaching English, or a health workshop)

YesNo
If you want to teach, please tell us what you could teach.
Do you want to perform?

YesNo
Great, please share your ideas with us
Do you have specific questions or topics you would like to discuss with professionals in these fields?
Is there a particular purchase you would like to make in Cuba?
Do you have any worries about the trip?
Would you like us to address any of them in our pre-travel info sessions?

YesNo
Should be Empty:

Travel Program Interest Survey