I would like to apply for the Teacher
Training / Continuing Studies program:
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First Name: | |
Last Name: | |
Address Line 1: | |
Address Line 2: | |
City: | |
State/Province: | |
Zip/Postal Code: | |
Country: | |
Home Phone: | |
Work Phone: | |
Mobile Phone: | |
Fax: | |
Email Address (enter twice to verify): |
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Web Site: | |
Gender: | Male Female |
Age?: | |
Best method and times to reach you?: | |
Are you fluent in Written English? |
Are you fluent in Spoken English? |
Mother Tongue: |
Other Languages: |
How did you hear about our program?:
Why are you interested in our program?:
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Background and experience with yoga: | |
How do you plan to utilize your training? (check all that apply): | Teach Full Time Teach Part Time Enhance/further your own personal practice
Apply in your profession - Please specify: |
Have you studied in the Himalayan Tradition of Swami Rama? |
Are you an initiate? Year? Who initiated you? |
Do you have an established daily practice? Hatha? Meditation? For how long?: | |
With whom/within what tradition(s) have you studied? Are you certified?: | |
Have you taught yoga? If so, how long and what type or style?: | |
What are your interests outside of yoga?: | |
Please tell us anything else about yourself, background, interests, etc.?: | |
Which retreat do you anticipate attending? Separate registration is required for the retreat, please register as early as possible.
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| As part of being enrolled in the program, you are required to have a mentor. If you wish you can recommend a mentor, perhaps your current yoga teacher. Fill in the following information to suggest a mentor:
Mentor's Name:
Mentor's Email:
Mentor's Phone:
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I have thoroughly read and understand this multifaceted program and hereby apply for acceptance into: |
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Check the spam code: | |