bodymindlife

Application Form

First Name:*
Last Name:*
Email:*
Address:*
Suburb / City:*
State / Territory:*
Country:*
Post Code / Zip:*
Mobile:*
Home Phone:*
Gender:*
Age:*
Marital Status:*
Emergency Contact Number:*
Emergency Contact Name:*
How did you hear about this?
If other, please let us know:
Please let us know about your yoga experience. How long you have practiced, regularity and styles/traditions you practice:*
In 200 words or less, please let us know why you wan't to be become a yoga teacher. Or if you are uncertain about teaching, why you want to participate in this program?*
What are you expecting from this training?*
Do you have a regular meditation practice?*
Do you currently teach yoga? Detail your experience and where you feel your weaknesses are:*
Please rate your health:
As we will be increasing the level of yoga practice that you may be used to, please check and make sure your doctor or physician OK's your participation in this training. Have you recieved the OK from your doctor?
Please list any physical or mental conditions that you are recieving treatment for, including medications you are currently using:*
Check which of the following you would like to improve on in your life:
Which course/s are you interested in: