TT Application: Ashtanga with Marilou (RYT200)

Ashtanga Teacher Training Application with Marilou van Hoek
We are happy you want to join Marilou on this amazing journey!

This is STEP 2 of the application process. You should have completed Step 1 first: Enrolling and paying a fee.

Please complete this application, sign it and submit it.
- Once we have your completed application we will email you within 3 working days if it is approved.
- About 2 months before the training starts: you will recieve a welcome mail with a lot of nice things you can already get started with!
  
  Enjoy getting started on your journey!
Full Name*

First NameLast Name
What is the name you would like to have on your diploma/certificate?*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Email*
example@example.com
Confirm Email*
example@example.com
Phone Number*

Area CodePhone Number
Date of Birth*

DayMonthYear
Date
Gender*

FemaleMaleNon-binary
Facebook name:
Your Photo: Please upload a photo of you

Cancelof
Emergency contact person & phone number*
Please enter name, relationship, phone and email
How did you hear about this program? (be as specific as you can please in blank below this question)

Referral: who referred you?Google search: What did you search for?I am a student at Yoga MovesAdvertisements: Which media?I am a student at _______?Social Media. Recall which?Other
How I heard:
ABOUT YOUR YOGA EXPERIENCE
How long have you been practicing yoga (any style)?*

Less than 1 year1 -2 years3 - 5 years6 - 10 yearsMore than 10 years
How long have you been practicing Ashtanga Vinyasa yoga?*

Less than 1 year1 -2 years3 - 5 years6 - 10 yearsMore than 10 years
How many times a week do you practice yoga in a lead class (live with a teacher...not online for example) on average?*

1 - 2 times a week3 - 5 times a week6 or more times a week
How many times a week do you practice yoga on your own mat (at home or Mysore) on average (at least 30+ minutes)?*

1 - 2 times a week3 - 5 times a week6 or more times a week
What style(s) of yoga do you practice?*

Ashtanga YogaVinyasa / Flow YogaRelaxed / Yin / Restorative YogaAlignment based (e.g. Iyengar) YogaHatha YogaHot YogaOther
How often do you practice the entire Primary Series?*

I never/hardly do1 - 2 times a month3 - 5 times a month6 or more times a month
Briefly describe your practice: what you love and where you are challenged.*
Which physical en mental challenges do you experience during your practice?*
Did you follow courses for personal development or other body/mind courses?*
TEACHING EXPERIENCE & ABOUT YOU
Do you presently teach a mind-body discipline?*

YesNo
If yes, please tell us what, if any teaching experience you have (yoga?) other relevant experience.
Have you completed a yoga teacher training before?*

YesNo
If yes, please mention name of school, teacher and style of yoga
MOTIVATION: Tell us why you want to follow this program? What are your expectations for this training? What do you hope to achieve personally?*
Why do you practice yoga*
ABOUT YOUR HEALTH (Confidential)
How to you rate your overall health right now?*

ExcellentGoodFair (describe below)Some Challenges (describe below)
Can you elaborate on the specific issues you mentioned above?
Do you have any injuries, medical conditions, surgeries or mental health challenges? (anything that may affect your participation in the training?). Please be specific.
Are there any other 'situations' that might effect your participation?
FINANCIAL AGREEMENT
I am applying for the Ashtanga Teacher Training given by Marilou van Hoek's company: Pranayama.nl and hosted by Yoga Moves starting:
I have chosen one of the following financial arrangements: *
Prices are listed on the yoga moves training page website and the amount I pay will be reflected on my bsport enrollment and payment choice for which I have received an email receipt.
GENERAL CONDITIONS AGREEMENT
SIGNATURE: By signing this I acknowledge that I have read and agree to these terms.*
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Ashtanga Teacher Training Application with Marilou van Hoek

ABOUT YOUR YOGA EXPERIENCE

TEACHING EXPERIENCE & ABOUT YOU

ABOUT YOUR HEALTH (Confidential)

FINANCIAL AGREEMENT

GENERAL CONDITIONS AGREEMENT