Nimble Arts Teacher Certification Program Application

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First name of applicant *

Last name of applicant *

Mailing address: Street *

Mailing address: City/State or Province *

Mailing address: Zip Code or Postal Code *

Primary phone *

Email *

If you are not yet 18 yrs old, please provide contact information for Parent/Guardian (Full name, relationship, email & telephone number)

Please indicate the Foundation Level Concentration area you would like to currently seek certification in. If you would like to complete multiple concentration areas simultaneously please check multiple areas. If you have already completed your Foundation level certification, please contact your Mentor to begin your Intermediate level training. *

Aerial Fabric

Trapeze

Rope

Lyra/Hoop

Sling/Hammock

Required

Please indicate any teaching experience you have (if any) including physical and non-physical topics.

Please indicate any past or current injuries and physical issues that would affect your physical training.

Please tell us why you wish to participate in the Teacher Certification Program and what you would like to accomplish.

Please indicate below how you found out about the Teacher Certification Program.

From current/formers Nimble Arts students

from the Internet

From poster / ad

From an email / brochure

From the New England Center for Circus Arts

Other:

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