AWE Program Application
Thank you for your interest in Accessible Wellness for Every Body!
This training will be a remarkable journey for your growth. When this form has been successfully submitted, you will see the confirmation message: "Thank you for your application. We will be in touch with you shortly.” You will also be emailed a copy of your responses.
We will review applications and reply by email within 5 business days.
* Required
Email address
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Your email
Name
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First and last name
Your answer
Street Address
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Your answer
City
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Your answer
State / Providence / Region
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Your answer
Zip / Postal Code
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Your answer
Phone number
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Your answer
Birthdate
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YYYY
Emergency Contact Name & Phone Number
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Your answer
How did you hear about this training?
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Your answer
Which of the following communities are you currently part of? Check all that apply
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CK Online Community
Willow Yoga
Zia Yoga & Wellness
I am not connected to a yoga community
Other:
Required
Depending upon restrictions, there may be opportunities for us to meet in person. Which of the following locations do you prefer?
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Willow Yoga in Lancaster, PA
Zia Yoga & Wellness in Exton, PA
I prefer to only meet online
Job Title & Employer
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Your answer
What if any wellness or leadership trainings have you completed? (name and date)
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Your answer
List three principal commitments in your life currently. (Please list in order of importance.)
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Your answer
Please state the main reason you are interested in this program.
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Your answer
What will you use this program for, once you have completed it?
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Your answer
This program asks for you to commit to your wellness by attending classes and living mindfully. Please explain how you will meet this commitment.
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Your answer
Is there a specific aspect of your wellness that you would like to impact during the program? Why?
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Your answer
Describe your level of wellness and what you do to maintain it.
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Your answer
We will be in a strong physical practice with group work and self-inquiry. Do you have any pre-existing conditions that would impact your participation in the program? Are you currently on any medications or under physical or psychological care? (If yes please explain)
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Your answer
What, if any, experience do you have with: Meditation/Mindfulness, Breathwork, Self-Inquiry and a physical yoga practice?
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Your answer
A copy of your responses will be emailed to the address you provided.
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