Teacher Training Application :: Plymouth Yoga Room -- Wayne County's Premier Yoga Studio in Plymouth, Michigan

Teacher Training Form

Name:

Street Address:

City:

State:

Zip:

Email:

Mobile Phone:

Home Phone:

Occupation:

Gender:

Male

Female

DOB:

Marital Status

Emergency Contact:

Name:

Phone:

Relationship:

Do you currently practice yoga?

Yes

If yes, where?

Do you currently attend classes at Plymouth Yoga Room?

Yes

Please list your previous yoga experience (length of time, types of yoga).

Please List any NON-Yoga personal growth, transformational based courses, workshops, seminars or retreats you have completed.

Why are you interested in the Yoga Immersion Program?

What are your expectations from this program.

What do you hope to gain,learn or work through.

Are you willing to follow a strict regimine during the Immersion process?

Yes

Do you have the support of your family?

Yes

How is your current health?

Excellent

Good

Fair

Challenged

Please detail your current health and health history.

Please detail any other pertinent information not covered above.