Yoga Therapy Application Interest Form 
Please complete the application form. This allows us to know where you are coming from and how to place you into the program. 

We are so excited for your interest in enhancing your profession as a Yoga Therapist. This work is so needed in the world and we are honored to partner with North Western Health Sciences University's Institute for Integrative Care to offer this opportunity to you. The 1000 hour accreditation includes your initial 200 RYS education, an accredited 300 RYS (or completed through MelMarie Yoga), and then the Professional Yoga Therapy program is the final 500 Hours including 300 hours of education and 200 hours of Yoga Therapy Delivery. Once you complete the form, we will be in touch to share more information and the next steps to move forward. Mel will be in touch to discuss more with 3-7 Business days. For further questions contact melmarieyoga@gmail.com or call 704-962-0771
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Email *
First and Last Name *
Current Date *
Email Address *
Mailing Address *
Phone Number *
How did you hear about us? *
Are you any of the following?  *
Required

Education Background: Include high school, college, post-grad, names of schools, degrees, majors, and any other education that would provide background for this training (i.e. massage, certifications, medical, etc.)

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How many years have you been practicing yoga?

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Please describe your Yoga Trainings including school name, hours and program focus:

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Please describe your interest in yoga therapy and which populations, demographics, specialities that interest you as the work of a yoga therapist.

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Do you practice meditation? If so, please describe your practice.

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Do you currently teach yoga? Please describe.

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Do you have physical injuries or medical conditions? If so, please describe.

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The Integrative Yoga Studies Professional Yoga Therapy Program is an advanced education pathway and requires students to be an RYT 500, have you completed your 300 Hour Yoga Teacher Training and if yes where did you graduate? 

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If you are not an RYT500 and would like to begin the Yoga Therapy Program, we would begin you in our Yoga Therapy 300 Hour Yoga Teacher Training. Please express if you are interested, time frame of when you want to begin and Mel will reach out to you soon. List questions here as well. N/A if not applicable 

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Any other information you want us to know as we consider your application.

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