Registration: 580-hr. Professional Diploma in Yoga Therapy

This form is for all those who wish to register for the Advanced Yoga Therapy Skills for Mental Health CPD.

Please complete the registration form below and remember to book your phonecall with Course Director Heather Mason via the widget within the form to discuss your application.
Name

First NameLast Name
Pronouns
Email
example@example.com
Phone Number (please remember to specify your country code if not using a UK number!)
Phone Number (please remember to specify your country code if not using a UK number!)
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Yoga Teacher Experience
Training course start date:

DayMonthYear
Date
Training course graduation date:

DayMonthYear
Date
Name & Details of training course:
Any additional relevant training:
Yoga Therapy Experience
I have an accredited yoga therapy qualification
If you have not completed a yoga therapy qualification, but have extensive experience in using yoga for mental health populations and would like to be considered for this course, please provide further details below:
The name of your current yoga therapy training/qualification
Yoga Therapy training course start date:

DayMonthYear
Date
Yoga Therapy training course graduation date:

DayMonthYear
Date
Total hours of the qualification
What is the name of the yoga therapy school you trained with?
Education, Experience and Statement
What is the highest level of education that you have achieved?

Other
Please state your main reasons for wanting to undertake this course.
Medical Conditions and Support Details
Please tick below if any of the below apply to you.
Is there anything related to neurodiversity or learning differences that you’d like us to know so we can support your learning in the most effective way? (E.g. Autism, Dyslexia, Dyscalculia, etc.)? If so, please provide details below:
Do you think you require support or adaptations while attending this course?
If you said yes to the last question, please provide details concerning the support that you will need whilst training with the Minded Institute:
Please provide details of any PAST/PRESENT mental health issues that we may need to be made aware of: (please leave as N/A if not applicable)
Please provide details of any CURRENT mental health issues that we may need to be made aware of: (please leave as N/A if not applicable)
Booking your initial discussion

Please use the booking system below to arrange your application with Course Director Heather Mason. Please remember to complete the remainder of this JotForm once you have booked an appointment!
Please note that our Course Director Heather Mason will phone you using the phone number entered in this form. If you are not able/ready to book a phone call, please select one of the options found below the booking platform. If you're having any issues accesing the booking platform, the direct URL is: https://calendly.com/themindedinstitute/advanced-yoga-skills-initial-discussion
If you would like to book a slot further into the future (slots are generally released 2 weeks in advance), or if you cannot find a timeslot listed that you can attend, please indicate this below and we will get back to you.
If you have not booked an appointment directly, t would be appreciated if you could let us know why in the box below. If you could not find a suitable time, please indicate some availability options below.
Staying in Touch

Your privacy is important to us. We’d like to keep in touch so please complete your contact preferences below. (Please tick all that apply)
How did you find out about this course?
If you ticked other please provide details below
Other
If you have been referred by an existing Minded student, please leave their full name in the box below. If you have a discount or referral code from another organisation, please input it below. *
If you were not referred by an existing student, please write n/a
I am happy for the Minded Institute to contact me by:
Confirm your Registration
I confirm that the information I have given is a true and correct record and I give my consent to The Minded Institute processing this information in accordance with GDPR and the Data Protection Act 2018.
Personal Data

If you have any questions about data protection at the Minded Institute or would like to request to change or delete your data please email: info@themindedinstitute.com.
Queries

If you have any queries concerning the completion of this form, please contact info@themindedinstitute.com
Should be Empty:

This form is for all those who wish to register for the Advanced Yoga Therapy Skills for Mental Health CPD.

Yoga Teacher Experience

Yoga Therapy Experience

Education, Experience and Statement

Medical Conditions and Support Details

Booking your initial discussion

Staying in Touch

Confirm your Registration

Personal Data

Queries