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Shanti Heart Yoga
Fall 2021 Yoga Teacher Training
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Street Address, City and Zip
Phone Number
Date of Birth:
Current Occupation:
Emergency Contact Name and Phone Number
Are you interested in the weekend or weekday program?
Relation of Emergency Contact:
Describe your current physical health - injuries or conditions you would like to make us aware?
Tell us a little about yourself. What are your hobbies and what do you enjoy about life?
What are some of your strengths?
In what areas of your life do you desire to move forward?
What do you desire to receive from our training program?
What part of Yoga interests you the most?
Are you ready to commit the necessary time, energy and financial resources to successfully complete the program?
Why do you desire a Yoga teacher Certification?
What are your long terms goals in Yoga?
What other goals do you have for yourself and your path, beyond this training?
Please list details of any previous Yoga training in which you have participated. (If this does not apply, reply N/A)
Please list any additional training, certifications or degrees you have received (i.e. college degrees, massage license, nursing, etc.) Also mention the institutions from which these credentials came. (If this does not apply, reply N/A)
How did you hear about this program?
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