Yoga Teacher Training Application

Name*

First Last

Pronouns*

Address*

Street Address Address Line 2 City State ZIP Code

Phone*

Email*

Date of birth*

Emergency contact:

Emergency contact name*

First Last

Emergency contact phone*

Relationship to contact*

Yoga Experience

Please describe your first or favorite experience with yoga.*

Please list the styles of yoga you have experience practicing.*

Please describe your current yoga practice.*

If applicable, please share any influential yoga teachers you have studied with directly.

Getting to Know You

What appeals to you about completing a yoga teacher training?*

Why do you want to participate in Glowing Body Yoga Teacher Training?*

If applicable, what are your specific interest areas related to yoga?

Please tell us about yourself. (Family, work, pets, education, hobbies, etc.)*

Please tell us about yourself as a learner. (Preferred learning styles; learning difficulties or challenges; study methods; desired resources; preferences for working individually or in groups.)*

How do you problem-solve and collaborate effectively when working with others?*

What questions do you have for the program administrators?*

Please share what days/times you are typically available for an interview (30-45 minutes) with a program administrator?*

The following will be used by our training staff to better assist you during training. Your information will be kept strictly confidential. Please tick the appropriate box and explain any affirmative answers.

Opportunity Enrollment

Yes, please consider me for Opportunity Enrollment*
No, do not consider me for Opportunity Enrollment

*Each year, we reserve spaces in our program at a reduced cost, in an effort to improve access for individuals who are experiencing hardship or disadvantage. If the following statements apply to you, please indicate if you would like to be considered for Opportunity Enrollment. *I frequently stress about meeting basic needs * I have debt and it sometimes prohibits me from meeting my basic needs *I rent lower-end properties or have unstable housing *I do not have a car and/or have limited access to a car but I am not always able to afford gas *I am unemployed or underemployed *I qualify for government assistance including food stamps & health care *I have no access to savings *I have no or very limited expendable income *I rarely buy new items because I am unable to afford them *I cannot afford a vacation or have the ability to take time off without financial burden These statements developed by Alexis J. Cunningfolk, https://www.wortsandcunning.com/blog/sliding-scale

Are you taking any prescription medication?*

Yes
No

If "yes" please list/describe medications.

Physical limitations or disabilities?*

Yes
No

If "yes" please list/describe limitations or disabilities.

Serious illness?*

Yes
No

If "yes" please list/describe illnesses.

Surgeries?*

Yes
No

If "yes" please list/describe sugeries

Have you or do you use or consume:

Tobacco*

Yes
No

Alcohol*

Yes
No

Recreational drugs*

Yes
No

Illicit substances*

Yes
No

If you answered yes to any of the above, please describe your usage.

Please confirm that you understand it is your responsibility to disclose any health information which may be relevent to your training experience.*

I understand it is my responsibility to disclose important health information to the lead trainer.

By clicking "I agree" I hereby attest that all information provided is correct. I also agree to adhere to the terms set forth by The Glowing Body.*

I agree