Application for Grounded By Yoga 200 RYT Program

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Welcome Lovely Yogi....

You may submit a check, money order or in person for cash if you prefer to not submit online however, we can not save your space until Deposit & Application fee arrives.

If you do choose to submit another way than online, please request a PDF of this application to complete.

Mailing Address: Sandy Hicks 8901 Belcher Rd Bloomfied, NY 14469

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Place the name of the program (Example: 200 hour, 500 Hour etc)* This field is required.

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Application Date:* This field is required.

Date

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Full Legal Name:* This field is required.This will also appear on your certificate.

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Full Legal Address* This field is required.

Address

Town/Zip

Country

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Phone Number:* This field is required.

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Date of Birth* This field is required.

Month/Day/Year

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Email* This field is required.

You will need regular access to your email before and during the program.

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If employed: Profession/Employer:* This field is required.

Please write "retired" or "none" if applies

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Medical/Medication/Physical Concerns:* This field is required.

Please write "none" if that applies

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Any Current Yoga Certification? (list school and type of certification):* This field is required.

Write "none" if that applies

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Emergency Contact:* This field is required.

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Emergency Contact Phone* This field is required.

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What name do you like to be called?* This field is required.

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How did you first hear about this training?* This field is required.

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If you require a payment plan, please detail here.* This field is required.Payment in full is required 60 days prior to graduation.

Put your monthly payment plans here or write Will Pay In Full upon acceptance.

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Are you aware that either Payment in Full or a signed Payment Plan Agreement is required within 7 days of the application date or your deposit is forfeited? Balance must be cash, check, money order to receive cash discount.

Yes, I am fine with thatNo - Can you call me as I will need more time to decide if I am paying in full or needing a payment plan?

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1. How long have you been practicing the yogic life? Please briefly describe how your practice has developed over the last year,including style(s) or lineages and meditation. Perhaps you have lived a spiritual life, without specific yogic practices, tell us about it.* This field is required.

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2. Yoga is the practice of removing obstacles and returning to our Self, is this something you feel you are prepared to do? * This field is required.

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3. Has any yogic sage (a Swami or Sri) influenced you on your yogic path? If so, whom?

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4. Where do you currently practice or who is your main teacher?* This field is required.

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5. Briefly describe your lifestyle and food choices. (Ex: Gluten Free, Vegan, Vegetarian, Hiking etc) Also list any food allergies you have :* This field is required.

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6. What is your understanding of yogic philosophy? The answer "none" is perfectly acceptable* This field is required.

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7. What do you hope to come away with at the completion of this program and how do you plan to apply yourself? (maybe you are seeking knowledge and self transformation, that's fine! Please note: I/we cannot force someone to heal - holistic yogic tools are provided - the rest is up to you! )* This field is required.

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8. Where is your life's dharma right now, what are you currently working on, if anything, (ex: grief, stress, feeling stuck, etc)* This field is required.

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9. Are you prepared for commitment and dedication in the program & your own practice?* This field is required.

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10. Briefly, in one sentence only: What IS Yoga? (no wrong or right answer here!)* This field is required.

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11. Briefly, in one sentence only: What is Yoga NOT? (no wrong or right answer here!)* This field is required.

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12. Please summarize why Grounded by Yoga seems like the best school to light your path* This field is required.

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13. This being an educational program, there will be homework assignments and quizzes. This requires orginizational skills. You will also need use of a computer and printer and checking of emails. Are you ok with this?* This field is required.

Yes

No

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14. Communication is required via email throughout this program. Do you have access to emails at least once per week?* This field is required.

Yes

No

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15. This training may or may not involve public practicum, are you ok with this?* This field is required.

Yes

No

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16. Do you have any cognitive, learning disabilities, mental illness concerns that might interfere with reading, assignments, information retention? If Yes, Please elaborate in the next box.* This field is required.

Yes

No

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17. If answered "Yes" to the above, please elaborate below. GBY wants to be sure we can provide properly - as a certification requires material retention and a passing grade.

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18. How would you like your name printed on your completion certification?

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19. Our studio / building has a no cell phone policy, kindles, computer watches, etc are you ok with that?* This field is required.

Yes

No

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20. You are required to get Yoga training insurance by January 15th 2025 Are you ok with this? (we suggest BeYogi its about $60-70 and you can use AFTER training as well (last we knew)* This field is required.Feel free to Google the best service/price etc.

Yes

No

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TERMS OF AGREEMENT/REFUND POLICY for any Teacher Training Enrollment at Grounded by Yoga Studios & Yoga Teacher Training Center LLC (GBY)

Additional Terms of Agreement for Payment Plans are listed on Payment Plan Agreement if Payment Plan is needed.

REFUND POLICY

· Refunds will not be granted 30 days after first payment is received or 45 days before the official start of our session, whichever comes first. Official start is when we begin our online initial study called Flex Time. Student is liable for complete tuition payment and court fees, collections, etc, if needed. GBY is not responsible for acts of God, pandemics or natural disasters, and etc. Should GBY’s program become interrupted, GBY promises to continue the program once it can be resumed.

· If student encounters something they view as an obstacle (injury, loss, etc). GBY strongly encourages you to continue your sessions. The knowledge delivered will lend itself to these stresses. Student need not be physical and may absorb the knowledge by observing. Future internship or makeup session(s) can assist in teaching certificate once the student is ready. (An addendum to this shall be written and signed by both parties regarding internship/makeup sessions and will include additional costs per contact hour and for preparation. Rates below).

· For our 200Hour Program, timely refunds are subject to a $525 admin fee and for a CEU program there is a $150 admin fee. Remaining credit, if any, can be used towards a future 200Hour training within 2 years of this application date. Credit not used on a timely basis will be forfeited. GBY cannot promise there will be a subsequent training, or a training of the same material.

· Books, Public Classes, Insurance, Wall Certificate or any Workshop fees are at the cost of the student. See website for up-to-date estimates of the aforementioned. GBY does its absolute best in keeping these costs as low as possible for the student. GBY supplies some books for you throughout the program.

· GBY reserves the right to cancel this training if there are not enough attendees. Student would then be given 100% monetary refund. (note: this has yet to happen).

· GBY has the right to cancel this training or reschedule weekends should there be a studio emergency (ex: no heat, fire etc) or weather-related concerns whereas other businesses are generally closed. (note: this has yet to happen), or if the lead instructor has a health emergency or immediately family passing.

· If Student changes their address, phone number or email this needs to be supplied to GBY

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COMPLETION REQUIREMENTS for any Teacher Training Enrollment at Grounded by Yoga Studios & Yoga Teacher Training Center LLC (GBY)

Additional Terms of Agreement for Payment Plans are listed on Payment Plan Agreement if Payment Plan is needed.

100% of attendance is required by the World Yoga Federation and Grounded by Yoga. Should you need to miss any time, please notify the director immediately via phone call to 585-229-9369. Make up sessions are at the discounted cost of $95 per hour Tuesdays, Wednesdays, Thursdays afternoon/evenings and $115 per hour Fridays or Sundays. Makeups are required before next session of training. Be sure the schedule works for you. Zoom may also be available as well as Director will do everything possible to keep hours of make-up low. You will only have to make up non-elective portions in person/zoom. All else may be made up via assignments at no cost.
Poor attendance or attitude and/or lack of efforts can result in expelling of student. Full tuition satisfaction shall still be your obligation. GBY Director will first speak to you to see where improvement can be made. (Due to the nature of this program -we cannot allow a student to "come as they please". If makeups are not completed by next session, you will be submitted as incomplete and will need to re-enter a future teacher training program for a teaching certificate. However, knowledge certificates still may be granted if time loss is minimal of 1 weekend).
Tardiness is not allowed. However, we understand winter weather and unexpected delays.
All assignments must be completed on their due dates.
Completion of tuition payments are required before a signed certificate will be provided. Tuition is generally needing to be paid in full 2 months (60 days) from graduation date of this program unless a written agreement for other terms are provided and signed by both parties.
An average of 80% or higher is required for graduation. You can do it! We are here to see that you do. GBY has never “failed” anyone.

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I understand and accept the Refund Policy and Completion Requirements above. By submitting this application form you acknowledge the information regarding tuition, refunds, attendance and graduate requirements. Please provide your full / legal signature* This field is required.

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$150 Application Fee & $500 Deposit for Teacher Training200 Hour Yoga Teacher Training includes $150 non refundable application fee and $500 Deposit of Tuition
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