Course Application Form

Name *

First

Last

Email *

Phone Number (Please include Country Code)

Address *

City *

State *

Postal Code

Country *

Date of Birth (DD/MM/YYYY) *

Gender *

Occupation *

Have you attended any course or workshop with us before? If so, please tell us when and where.

Please select a course you wish to attend. *

CBC-FTC LV2 Ubud Bali, Indonesia (3 - 9 February, 2020)
Gliding Space-TTC Ubud Bali, Indonesia (10 February - 7 March, 2020)
CBC-FTC LV1 Ubud, Bali, Indonesia (12 - 18 April, 2020)
CBC-FTC LV3 Bali, Indonesia (21 - 29 October, 2020)
CBC-TTC LV4 Bali, Indonesia (1 - 16 November, 2020)

Please tell us about your backgrounds / previous experience in dance, movement practices and/or any embodied practices. *

Please tell us the reason why you wish to take this course and what do you wish to gain out of this course. *

Where did you hear about this course?

Do you have any health conditions that we should be aware of during the course?

AGREEMENT CHECKLISTS *

Before you submit your application form, please read through our Terms & Conditions
and make sure all your information are corret.

If you don’t hear back from us within 3 days, maybe there was submission error. In that case, we kindly ask you to get in touch with us at education@unityspace.org