Private Yoga Applicant Form
Name
*
First Name
Last Name
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Request by Class Type or Energy Level preferred:
*
Class Type
Energy Level
Enter Class Request
Choose energy level:
Relaxing
Medium
Instructor preference?
*
No
Yes
Which Instructor?
Choose Duration:
*
45 minutes
60 minutes
90 minutes
120 minutes
1-on-1 class, or small group?
*
1-on-1 Class
Small group
How many in your group?
Please Select
2 people
3 people
4 people
5 people
6 people
7 people
8 people
9 people
10 people
11 people
12 people
Would you like to save by purchasing a class package?
*
No, just 1 class please
Yes
Choose a class package (addt'l $5 off per class up to 4 total)
Please Select
2 classes for the month
3 classes for the month
4 classes for the month
Please enter requested times and dates for all classes requested. (e.g. "Fridays at 3:pm for 3 weeks starting on [date])
*
Best method to contact:
*
Text Message
Phone Call
Email
Submit
Should be Empty: