Yoga Teacher Training Registration

General Information
First Name*
Last Name*
Gender
Address 1
Address 2
Province / State
Country
Primary Phone
Work Phone - Ext.
E-mail
Date of Birth
(YYYY/MM/DD)
Education / Yoga Experience
High School Graduate?
Post Secondary Education?
Current Occupation
Do you currently teach Yoga?
If yes, please describe in detail what and where you teach.
If no, please explain why you want to teach yoga.
Please describe your yoga background.
Have you studied any other Eastern systems of the body?
(e.g. Tai Chi, bodywork, martial arts, acupuncture, etc.)
Have you studied any Western systems of the body?
(e.g. dance, Pilates, Feldenkrais, etc.)
Have you ever been injured as a result of your yoga practice?
If yes, please provide a detailed description of the injury.
Are you currently using any prescription medication?
If yes, please name the medication, reason for taking it, and provide a brief medical history.
(All information provided by you is confidential.)
Other
Which Yoga Teacher Training Program are you applying for?*
How did you hear about our program?
Discuss the reasons why you would like to take this program.
Other than yoga, what are your interests and hobbies?
Is there any other information you would like us to know about you or your interest in yoga?
Comments
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General Information