Application for Asana Intensive for Yoga Teachers Online

Name*

First Last

Mailing Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Email*

Enter Email Confirm Email

Phone Number*

Which style(s) of yoga do you practice and how long (months and/or years) have you been practicing?*

Which style(s) of Hatha Yoga are you certified to teach?*

Approximately how many hours of teaching experience do you have?*

Are you currently teaching yoga? If so, who are your typical students?*

If you are a certified Level 1 Ananda Yoga teacher, or a Bridge to Ananda Yoga graduate, and seek Level 2 certification, please tell us your graduation date and the name on your Level 1 certificate.*

If you are not a certified Ananda Yoga teacher, and wish to take this course only for your own learning, please tell us your name as it reads on the Yoga Alliance teacher directory. If you are not registered with Yoga Alliance, please describe the yoga teacher training that you have received.*

Have you practiced Ananda Yoga? If so, how much? If not, why have you chosen Ananda's training and what do you hope to gain from this course?*

Please acknowledge that you have read the Frequently Asked Questions for this course*

Yes
No

Asana Intensive FAQs

If you anticipate being unable to participate in one or more of the Saturday and Sunday workshops, please tell us the dates that you expect to be absent. Ananda Yoga teachers who seek Level 2 Ananda Yoga® teacher certification can miss no more than two workshop, and even missing that will involve a makeup video-creation assignment.*

Terms & Conditions for Asana Intensive for Yoga Teachers

Participants must agree to the following terms & conditions for this course:

a) You will not share the course materials with anyone.

b) For certified Ananda Yoga teachers and graduates of Bridge to Ananda Yoga, credit toward Level 2 Ananda Yoga teacher certification after this course depends upon:

Full, regular, and meaningful participation in all course activities.
The faculty’s assessment of your teaching.

c) Cancellation Policy: If you cancel more than 14 days before the start of the program, your payment will be refunded, less a $100 processing fee. If you cancel within 14 days of the start of the program, 50% of your payment will be refunded, and the remainder will be forfeited. If you cancel more than 14 days after the start of the program, the full program cost will be forfeited.

Accept Terms and Conditions*

Yes

Medical Questionnaire: What is your birthdate? (Day, Month, Year)*

Please briefly describe your current overall health.*

Describe your history (include dates) of back/spine/neck problems, and indicate if you are currently having any issues. Please be specific.**

Describe your history (include dates) of joint problems (knee, hip, shoulder, etc.), including joint repair/replacement surgeries. Please be specific.*

When was the last time your blood pressure was checked and was it normal, high, or low?*

Are you pregnant? If yes, when is your due date?

Are you currently seeing, or have you seen in the last 5 years, a physician or therapist for any physical or mental/psychological conditions? If yes, for what conditions?*

Are you currently taking medication for any physical or mental/psychological conditions? If yes, what medications, for which conditions, and how frequently?*

If you have any learning disabilities, or other special physical or mental/psychological circumstances, please explain below.*

Please check any of the following difficulties you have had and explain relevant specifics in the next question.*

Please explain the above health conditions you checked off in greater detail and with relevant dates.

Please share any other personal information that you feel we should be aware of, or concerns that you may have about this course.

Emergency Contact Name*

First Last

Relationship*

Emergency Contact Phone Number*

Emergency Contact Mailing Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Are you a Registered Nurse looking to receive CEUs for this course?*

Yes
No

RNs will need to fill out an additional application to begin this process.

How did you first find out about this course?*

If a teacher/friend referred you to this program, may we please have their name so we can thank them?

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