CONTACT INFORMATION ( * Required fields ) |
| * Your Last Name: |
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| * Your First Name: |
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| Daytime Phone: |
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| Evening Phone: |
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| Address: |
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| City: |
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| Postal Code: |
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| * Your e-mail Address: |
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| Date of birth: |
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| Occupation: |
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| Emergency Contact Name: |
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| Emergency Contact Number: |
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| Where
did you hear about this Teacher Training Program? |
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ABOUT YOU |
| Please describe your previous yoga and/or meditation experience, including a brief description of your current practice (style, frequency): |
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| Why would you like to become a yoga instructor, and what are your goals for the training? |
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| Why have you chosen this program in particular? |
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| *** Please submit a brief letter of recommendation from your yoga teacher, or someone such as a past employer who can speak to your commitment and character. |
MEDICAL INFORMATION |
| Do you have any physical injuries or limitations that might inhibit your yoga practice? Please be explicit. |
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| Have you had any previous surgeries? If so, please describe what and when. |
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| Are you taking any medication? If so, please describe the type of medication, its purpose, and how long you've been taking it. |
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| Do you have any history of mental or emotional issues relevant to these studies? Please be clear and know your submission will be kept entirely confidential. |
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A $500 deposit is due with the application form to secure your place in the program, and is refundable up to 10 days before the commencement of the program.
Cheques are payable to: Kathryn Downton |
BEFORE YOU CLICK ON THE SUBMIT BUTTON BELOW...
1. Please be sure you have filled in all * Required fields.
2. After you click "Submit Form to Lifesong Yoga" you will receive a "Thank you for applying for Teacher Training with Lifesong Yoga" message confirming that your registration has succeeded.
3. If you DO NOT RECEIVE a "Thank You!" message, your attempt to register has not succeeded and you will be taken to the top of this form where you will find an "Error" message, reminding you to go BACK one step (click the "Back" button on your computer) and fill in all * Required fields.
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