Healing in Motion Interest Form

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Following the success of our Dance and Diabetes research project, we have decided to create an organization dedicated to hosting dance classes for individuals with chronic illness. We plan to start in the fall and would love to have you on our team! No dance experience is required to be a member, and many executive board positions are available. This is a great way to gain pre-medical experience and give back to your community in a unique, innovative and fun way!

If you have any questions, feel free to contact Maebelle Mathew (maebelle.sm97@gmail.com), Akhila Boyina (akhib07@gmail.com) or Shweta Bhatnagar (shwetab@live.unc.edu). We look forward to hearing from you!

Name

Year

Rising Freshman

Rising Sophomore

Rising Junior

Rising Senior

Graduate Student

Clear selection

Why are you interested in this organization?

What is your dance experience? (No dance experience is necessary to be a member!)

What experience do you have on planning committees or other service organizations? (No experience is necessary to be a member)

What are you interested in? (Select all that apply)

Executive Board (Positions include: Co-President, Vice President, Treasurer, Dance Committee Chair, Planning Committee Chair)

Planning Committee (Includes fundraising, recruiting participants, and researching/arranging dance class logistics)

Dance Committee (Includes creating and teaching dance segments to workshop participants)

If you selected Executive Board, please list what position(s) you are interested in.

What is your availability like for the next school year?

Thank you for filling out this interest form! We will reach out to you shortly!

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