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Samskara Yoga School CEU Module Application
571-354-6165/
info@samskarayogava.com
ytt300.samskara.yoga
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Email
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Your email
Full Name
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Your answer
Mailing Address
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Your answer
Phone Number
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Your answer
Date of Birth
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MM
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DD
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YYYY
Current Occupation
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Your answer
Emergency Contact Name/Number
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Your answer
How did you hear about our 300-Hour YTT/CEU Program?
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Your answer
Which modules are you interested in taking?
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[ONLINE] Chair Yoga Clinic (Aug 20-22, 2021)
Vinyasa Yoga Clinic (Sept 2021 - official dates TBA)
Meditation + Yin/Restorative (October 2021 - official dates TBA)
Yoga YOUR Way – Accessible Yoga Clinic (November 2021 - official dates TBA)
Ashtanga Primary Series Teacher Training (December 2021 & January 2022 - official dates TBA)
CEU Modules in 2021
The full 300-Hour YTT Program
Other:
Required
Tell us about your current yoga and/or meditation practice (type of yoga/meditation, how often, how long you have been practicing)
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Your answer
Why are you applying to this program?
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Your answer
If someone came up to you and asked you why they should begin a yoga practice, what would you tell them?
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Your answer
Do you plan to teach yoga upon completion of this program, or are you looking to grow your own personal yoga/meditation practice?
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Yoga Teacher
Other:
Do you currently hold a 200-hour certificate of completion from a yoga school? If so, which one?
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Your answer
Are you currently teaching yoga? If so, where and what style(s)?
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Your answer
Do you have any other types of training related to yoga? Please include program names/types, hours of training, and where you received the training.
Your answer
Have you discussed participation in a rigorous and physically challenging program like ours with a medical professional?
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Your answer
Are you able to work within communities that are seeking yoga classes, but may have various obstacles to joining a studio, gym, or other "typical" yoga classes?
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Yes
No
Maybe
Other:
I will pay the balance of the tuition:
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In full (full payment is due 7 days before the module begins)
Payment Plan (email
chelsea@samskarayogava.com
for details)
I understand that after beginning this program or a module contained within the syllabus, I will not be given a refund for any reason. Prior to that date, I will receive a full refund minus a 10% administrative fee.
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Yes
Other:
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I understand that I am responsible for all additional costs, including books and media specifically related to the 300-hour YTT Training Program and/or CEU modules.
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Yes
Required
Send me a copy of my responses.
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