Apply here!

Name*

First NameLast Name
Phone Number*

Country CodeArea CodePhone Number
Date of Birth

MonthDayYear
Date
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Email Address*
example@example.com
Website
Emergency Contact Name*
Relationship to emergency contact. *
Phone number for emergency contact.*

Country CodeArea CodePhone Number
Date you received your 200 Hour Yoga Teacher Certification*

MonthDayYear
Date
Where did you receive your 200 hour Yoga Teacher Training? Please provide the name of the institution, address, and phone number of your school. *
Who were your primary trainers? Please provide name(s) and phone number.*
What style of yoga did you study?*
Was your institution Yoga Alliance certified?*
Are you a certified TRE Provider?*
Have you completed a consultation call with a trainer?*
Please list any other related trainings that you have completed.*
Please include, training or workshop name, institution, and date of completion.
What style of yoga do you practice for yourself now?*
What style of yoga do you currently teach?*
Have you ever practiced neurogenic tremoring (TRE or Neurogenic Yoga)? If so, how long have you been practicing? *
Why do you want to be Neurogenic Yoga Teacher Certified?*
Is there anything else you would like us to know about you?*
Additional Document Uploads

Please upload the following documents:
- Copy of your official yoga teacher certification and any other yoga related certificates.
- Log of 50 classes minimum of yoga instruction or a photo of you Yoga Alliance membership card.
- For TRE Providers only: upload your TRE issued certificate of completion.
Upload your documents here!

Cancelof
Payment And Submission

Submit payment by using links below, read acknowledgment statements and click submit. You will receive contact from our team upon receiving your application.
You may submit your $50.00 fee via Zelle (480)223-8686, Venmo (@JennicaMills)PayPal (jennica@neurogenicyoga.com), or Credit Card.
By clicking submit I am acknoledging that:
- I meet all program prerequisites, including a 200hr yoga certification, a minimum of 1 year teaching experience, and at least 50 documented teaching hours.
- I understand that the $50 application fee is non-refundable and must be submitted to complete my application.
- I understand that submitting this application does not guarantee acceptance into the program.
Should be Empty:

Additional Document Uploads

Payment And Submission