Name* First Last Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Email* Enter Email Confirm Email Phone Number* Which course dates are you applying for now?* July 2 - 12, 2023 July 2024 (10 days - Dates TBA) The above dates don't work for me, but I would like to be notified when future dates are decided on. Please share a little about yourself so we can get to know you. How do you spend your time when you're not doing yoga? (work, family, hobbies, etc.)*Please tell us your reasons for taking Bridge to Ananda Yoga.*Which style(s) of yoga are you certified to teach, and which school of yoga did you complete a 200-hr teacher training with? (For those seeking Level 2/ 500-hr certification, please include your YA registration number.)*Please email a copy of your 200-hr certificate to Melody (melody@expandinglight.org.).* Yes, I can do this. Which style of yoga do you teach? How much teaching experience do you have? How often are you currently teaching classes?*How many days per week do you practice and what is your average daily practice time? How many months/years have you been practicing this consistently?**Please be specific (i.e., how many months or years have you been practicing this often?)Have you practiced Ananda Yoga? If so, how much? If not, why have you chosen Ananda's training?*Ananda takes a classical approach to Yoga: as an aid in the quest for Self-realization, for union of soul with Spirit. Although Ananda Yoga Teacher Training takes place in that spiritual context, trainees are not expected to follow Ananda’s spiritual path; we encourage you to grow on your own path. Does this seem like a good fit for you?* Yes Not sure Do you practice meditation? If so, how often?* This is not a prerequisite for the course.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, how many weeks pregnant are you and 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.* Diabetes Stroke Seizures Eye condition Frequent diziness or falls Osteopenia-Osteoporosis Chronic Headaches Asthma Cancer Anxiety/Depression Trauma Abuse PTSD Addiction Substance Abuse Insomnia Other None of the above Please explain the above health conditions you checked off in greater detail and with relevant dates.*I hereby certify that the above information is correct to the best of my knowledge, and I will continue taking all medications as prescribed by my health care practitioners(s) while taking the Bridge to Ananda Yoga course.* If you are an international student, are you able to pass an English language proficiency test? Yes No Not sure Additional Questions: Do you have time to do approximately 6-8 hours of pre-course and post-course assignments (e.g. viewing videos, reading from the manual, and self-quizzes)?* Yes No As part of this course, you'll need to acquire a copy of "The Art & Science of Raja Yoga" book by Swami Kriyananda (J Donald Walters). You'll also be assigned some pre-course reading assignments from this book. (There are older and newer versions of this book. Any year is suitable. Amazon has an ebook Kindle version, or you can visit www.crystalclarity.com to order a hard copy.)* Yes, I will purchase the book before the training begins. Yes, I already have a copy of the book. Please share any other personal information that you feel we should be aware of, or concerns that you may have about this course.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?*Ananda.org websiteEmail(s) received from Online with AnandaEmail(s) received from Expanding LightReferral from past graduate of your training programReferral from a friendWeb searchSocial MediaYoga AllianceOtherIf a teacher/friend referred you to this program, may we please have their name so we can thank them? Have you taken any courses/classes with Ananda online or in person, or visited The Expanding Light Retreat and/or been involved with an Ananda center?*Do you already have an account created on ExpandingLight.org?*If you do have an account with The Expanding Light, please provide your username or email below (otherwise mark this field NA):*I have read and understood the Frequent Questions section (including requirements for completion, and the programs refund policy) (see link directly below).* Yes No During your participation in the program, we may be taking photos for marketing purposes. Do we have permission to use any photos and videos of you?* Yes No I prefer to decide once I am there in person. If you are accepted into the program, please pledge that you will not share any of the course materials with anyone.* Yes, I pledge not to share any course materials with anyone. 93989Δ