Creative Motion Alliance, Inc
Application for Level I Basic Certification
in Creative Motion Teaching
(Appendix A)

To apply you may complete the online form below, or download and complete the application form and mail to chair of the Certification Committee.


Date :

NAME
Salutation: Mr. - - Mrs. - - Ms. - - Dr.
First : Last:
Address and Contact Info
Mailing Address - Street Address:
City / Town : State / Province : Zip
Phone:
Other Phone:
E-mail 1:
E-mail 2:


WORKSHOP ATTENDANCE: Please list the dates of workshop attendance below. (It must equal 20 days):
Windswept Music Workshops: (dates)
Mini-workshops:(include city and dates)

Training and Degrees


Professional Activities


Are you prepared to take the Level I examination? yes no
Are your CMA dues current? yes no
Will you be paying your certification application fees online? yes no

Describe your experience with Creative Motion, your understanding of its concepts, and its use in your current activities.




If you wish to retain a copy of this form for your own records, please print this prior to pressing the Submit button.

This application will be reviewed by the Creative Motion Alliance's Certification Committee.
You will be informed of the committee's decision in a timely manner.