Holy Yoga Instructor Training Application
Name
First Name
Last Name
Email
example@example.com
Phone Number
Format: (000) 000-0000.
Street Address
City
State
ZIP Code
What is your current occupation?
Emergency Contact Information
Name
First Name
Last Name
Email
example@example.com
Phone Number
Format: (000) 000-0000.
Relationship to You
Tell Us a Little Bit About Yourself
Tell us a little about who you are generally; what you are passionate about; your family; work life; and your sense of purpose.
Current Age
Describe your personal yoga home practice. If you don't have a personal practice, what do see as the barrier(s)?
What are 3 adjectives someone might use to describe you?
About Your Interest in Our Program
What do you hope to learn and experience in this Holy Yoga Instructor Training Program? Describe your expectations of this program.
Is there an aspect of a yoga practice that is most important to you? Describe briefly.
Yoga Experience/Background
What is your yoga background? How long, what types, where and with whom have you practiced or taught (studios, individuals)? Please make your information as specific as possible.
Are you currently practicing outside of your home? If so, what are the styles that most resonate with you?
Do you have a meditation practice? If so, please describe.
Personal Goals
What are some additional goals you have for yourself?
Please list any additional training, certifications or degrees you have received (ie: college degrees, massage, nursing, etc.)
About Your Current Health
How would you evaluate your current health?
Excellent
Good
Fair
Some Challenges
Are you currently, or at any point in the last two years, been under the care of a physician or other health care professional for any reason?
Yes
No
If yes, please describe.
Do you have any injuries, chronic or acute?
Yes
No
If yes, please describe.
Is there anything else you would like us to know?
Full Name
Signature
Date
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Month
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Day
Year
Date
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