Name * First Name Last Name Email * Phone (###) ### #### Address Address 1 Address 2 City State/Province Zip/Postal Code Country List and describe your yoga teacher training experiences including: school or teacher, location and date, and program focus. Have you completed any specialized training, e.g., yoga therapy? Where? When? List and describe your teaching experience. Include how long you have been actively teaching, number of classes you teach each week, populations you teach, e.g., general classes, special populations, etc., levels you teach, and if teaching is your full- time work. Please include locations and total teaching hours. Do you include meditation or Pranayama in your teaching? What do you hope to gain from this training? How were you first influenced to practice Yoga? Please list any health related issues that you are currently experiencing; physically, mentally, emotionally, and any medications you currently take or doctor’s provisions. Do you have a home practice and if so, what does it consist of? What do you feel are your strengths as a teacher? What do you feel are your weaknesses as a teacher? Thank you! Advanced Yogic Studies100-Hour Teacher TrainingApplied Therapeutics APPLICATION
