Expressive Arts Florida Institute

Intermodal Expressive Arts Certificate Program
Application Form

Please complete the form below and email or mail in the additional documents.

Program of Study Applying for:

(check one) *

Level 1 Training

Levels 1 and 2 Training

How did you hear about Expressive Arts Florida? *

Personal Information

First Name *

Middle Initial *

Last Name *

What are your preferred pronouns? *

Date of Birth *

Street Address *

Address Line 2

City *

State/Province/Region *

Zip/Postal Code *

Phone Number *

Cell Phone *

Country *

Email Address *

Website *

Nationality *

Primary Language Spoken *

Citizenship: *

U.S. Citizen

Permanent Resident

Other Other

Profession *

Present Occupation *

Employer *

Present Position *

Emergency Contact

Emergency Contact Name *

Relationship *

Address *

Phone Number *

Email Address *

List all other training programs attended

Name and location of school *

Attendance dates *

Certificate earned (if applicable) *

Name and location of school

Attendance dates

Certificate earned (if applicable)

Name and location of school

Attendance dates

Certificate earned (if applicable)

Post-Secondary Education (Associates, Bachelors, Masters, Doctorate)

Degree *

Date of Graduation *

Name of Institution *

Course of Study *

Degree

Date of Graduation

Name of Institution

Course of Study

Degree

Date of Graduation

Name of Institution

Course of Study

Essay
Please attach a 3-4 page (double spaced) Autobiographical Essay describing personal and
professional goals as well as your experience with Expressive Arts and creativity. Essay to include
answers to the following:

• Why do you wish to study at Expressive Arts Florida Institute and what do you hope to accomplish
with the training?
• Describe your current work situation (if applicable).
• How are you currently using creativity or Expressive Arts in your current work setting and/or
life?
• Do you currently have a regular personal arts practice? If so, please describe.
• How do you see your creativity influencing your ability to problem solve, meet challenges, and
grow personally?
• Summarize your personal strengths, challenges, and areas for growth.

Interview
Admissions interview with Expressive Arts Florida Institute Advisor (this can be done by telephone
once application is received and reviewed).

Additional Information Required with your application:

• 2 Letters of Recommendation – one may be from an Instructor, Professor or Academic Advisor and the other may be from a Supervisor or Colleague. Recommendations must be completed on the
downloadable form found on website and must arrive in a sealed envelope. Recommendations may not be from family or friends.

• Current Resume. Included should be your educational background (colleges and universities
attended, a minimum of a Bachelor’s Degree preferred. If you do not hold a BA, we welcome you to
apply and request that you refer to admissions policy for specific guidelines.), work experience,
and any special skills that may enhance your application credentials.

•Official academic transcripts from all institutions attended. Transcripts in a language other

than English must be accompanied by a certified English translation. Transcripts must arrive in
their official sealed envelopes directly from the educational institution.

The Application for Admission and supporting documents must be in English and received no later
than the posted deadlines. As a general rule, incomplete applications or applications submitted without the application fee will not be processed (rare exceptions may be made depending on which element of the application is missing). Late applications may be processed according to the ability of the Admissions Office.

Application fee (Non-refundable)
The application fee of $175.00 is to be paid directly to the Expressive Arts Florida Institute at
the time of submission of this application. For cancellation and refund information, please refer to Admissions Policy for terms.

I am paying my $200.00 nonrefundable application fee with (Select Payment Method): *

Enclosed check (200.00)

PayPal via website at expressiveartsflorida.com (200.00)

Please check to see that all information is correctly completed.
Incomplete applications will not be processed.
I certify that the information given on this application is complete and accurate.

Signature *

clear

Print Name *

Date *

Please send this form with all necessary documentation to:
Via Mail:
Expressive Arts Florida Institute Admissions Office
200 South Washington Boulevard Suite 1
Sarasota, Florida 34236 USA

or via E-mail: create@expressiveartsflorida.com

Please be advised that enrollment in Expressive Arts Florida Institute Training Program is limited. Application does not guarantee acceptance. Expressive Arts Florida Institute reserves the right to choose the candidates for its certification program in order to maximize the educational and professional experience offered.

You will receive a response to your application within 30 days of receipt. Please do not hesitate to contact our Admissions Office. We look forward to hearing from you.

Statement of Non-Discriminatory Admissions Policy
Expressive Arts Florida Institute does not discriminate on the basis of race, color, national or ethnic origin, sex, creed, political affiliation, physical disability, age, marital status, personal appearance, family responsibilities, or sexual orientation, and admits students to all the rights, privileges, and activities generally accorded or made available to all its students.

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