Personal Information

Name

Address

City

State

Zip/Pin Code

Phone

Age

Date of Birth (YYYY-MM-DD)

Gender(required)

Female

Male

Preferred Pronouns

Marital Status

Occupation

Emergency Contact Name

Emergency Contact Phone

Relationship to Emergency Contact

Yoga Background

I have practiced yoga asanas

Yes

If yes, where did you learn yoga asanas?

I practice Meditation(required)

Yes

If yes, for what duration each day

What are you special talents, skills, hobbies and interests?

Is English your primary language? If not, what is?

What other languages do you speak fluently?

Please describe briefly:
Your experience with the teachings of Yoga and your personal spiritual background. Also briefly describe your family, educational and occupational background and explain why you are interested in becoming a yoga teacher.

Health Record

Do you have any dietary or health restrictions?

Do you smoke, drink, use recreational drugs, or have other addictive
behaviors? (If yes, specify)

Do you consider yourself healthy and well?(required)

Yes

If no, specify

Are you taking any medications?(required)

Yes

If yes, specify

Have you had any serious injury or disability? If so, please describe and include anything you feel we need to know that may impact your ability to participate in this training.

Agreement

I wish to learn the teachings of Integral Yoga and experience the yogic way of life. Therefore, I agree to abide by the guidelines of the teacher training program, which include following a lacto-vegetarian diet and refraining from the use of alcoholic beverages, cigarettes or recreational drugs during the duration of the program.

I certify that I am in good health and have no physical or mental ailments, except as may be indicated on this application. I further agree to assume full responsibility for any injuries or damages that might occur to me or my property during my stay.

Signature

Date (YYYY-MM-DD)

Application

Thank you submitting your Application

Personal Information

Yoga Background

Health Record

Agreement