Humanity First- Embodied Leadership Training 2022-2023
Training Dates:

Event Address:

Contact Kellie @
Email *
Name *
Pronouns *
Address *
Cell or Contact Phone Number *
Birthdate *
Emergency Contact Name & Phone Number *
Current Profession *
Relevant Education. Trainings & Certifications *
Are pregnant or recently gave birth (within the past 18 months). *
List any medication you are presently taking. List any surgeries you have undergone in the past ten years. *
List any chronic pain, joint strain, muscle strain or other physical issues that you presently have or ever feel in the course of a normal day or in practicing yoga. *
Please describe any physical or mental health conditions that might affect your participation in this program. *
Please feel free to add any other health-related information you wish to bring to our attention. *
What about this training speaks to you and why? *
How long have you been practicing Asana? Meditation? Mindfulness? *
What practices or styles have influenced you the most and how? What teachers have influenced you and how? *
Describe your personal practice(s)? *
What benefits does it bring you and what else would you like it to provide you with? *
Please tell me about your background with psychology/ psychiatry/mental health/spirituality/eastern based principles. *
Given the intensity of the emotional work of this training what is your support system (please be detailed). *
What fears or concerns do you have about this training? *
What do you want to teach after this program and why? If you do not want to teach, what would you like to take away from this program? *
What is essential about you that’s invisible to the eye? *
Please share what inspires you, including your hobbies, interests, likes and dislikes. *
What behaviors or lifestyle habits do you currently engage in regularly that you believe are self-destructive?
What else would be helpful for me to know about you? *
What to expect: Once you have submitted your application you will be notified we have received it. We will contact you to set up an in-person or telephone interview to complete the application process. We will inform you within 30 days of your application if you have been accepted or not. If accepted we will offer you the first available spot in the next available training. Thank you for your interest, your application and for letting us get to know you. We hope to see you in Humanity First! Please direct all questions and/or inquiries to: Kellie
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy