YMY 200 hour Teacher Training Application
Application for 200 hour YTT April 2022-December 2022
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Participant Name
Address
Gender Identity and Pronouns
Date of Birth
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Phone number
Emergency Contact (name/phone/relationship)
Employer/Occupation
Education/Skills
Because this teacher training immersion program is hosted by Bridge studio at Art of Awareness and Art of Awareness Wellness Center includes a therapy practice, we need to consider potential dual relationships and potential conflicts of interest when forming a teacher training group.Therefore, please answer the following question: Do you currently or have you in the past received therapy services at Art of Awareness?
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Why do you want to participate in this teacher training program? Also, what draws you specifically to the Yoga Muse School of Yoga 200 hour program?
Do you intend to teach yoga classes and if so please describe your inspiration/teaching goals.
How long have you practiced Yoga? Please include where and with whom you take classes, how often you take classes, and any workshops or trainings you’ve taken.
Please describe how Yoga has impacted your life and how you have benefited from your practice?
Describe your health: (Please include any major surgeries, illnesses or other physical, mental or emotional conditions including current/recent injuries or other specific needs and any drug allergies)
What do you expect to gain from this training program?
 Do you anticipate any barriers/challenges to fully participating in this 200 hour immersion? If so, please describe what resources you plan to use to help with these challenges.
Please list anything else you think it would be helpful to know about you.
Please select a payment option below
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 I acknowlege that By entering my name below I am signing this application, I certify that it is true and complete and that I understand and agree to the following payment policies: If accepted into the program  a non-refundable deposit of $500 is due within 7 days of notification of my acceptance to hold my space. Remaining tuition is due based on my choice of payment in full or a payment plan as  indicated above.
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