Dance Healing: Practicum Report Form

Dance Healing Level 3 Mentorship Practicum Report Form

Part 1) For internal use only.

First Name

Last Name

Have you facilitated your score for the public? Required

Yes

What was your theme and intentions for this offering?

Who was your audience? Was this the audience you intended to reach?

What was the time and space for your offering? Such as "3 weekly sessions via Zoom" or "one four-hour workshop in a park."

What were the activities you led?

Please reflect on your experience as a facilitator. What went well for you? What was challenging? What would you do differently next time?

Please share any testimonies / feedback that you received:

Please share what's next for you as a Dance Healing facilitator. What is inspiring you, what visions do you have, and how would you like to be supported?

Please add a mailing address to receive your certificate:

Part 2: For Embody Soul website public viewing:

Please share your mission as a Dance Healing Facilitator (1-2 sentences):

Please share your vision statement as a Dance Healing Facilitator (1-2 sentences):

Please share a brief bio for the Embody Soul website:

Please write how you want to be contacted by interested clients: website, social media, and/or email address.

Please upload your headshot.

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Congratulations! We will be in touch soon.

EMBODY SOUL

by Hayley Shannon

Dance Healing Level 3 Mentorship Practicum Report Form