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50-hr Yoga Nidra Training Application
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Email
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Full Name:
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Preferred Name:
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Date of Birth:
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Where are you based? (City/Town, State, etc.)
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What is your highest level of education completed (or currently enrolled)?
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What is your current occupation?
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Do you have any previous experience with Yoga Nidra?
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Why do you want to take this program and what do you hope to gain?
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Please describe your existing yoga, spiritual, or therapeutic practice, including any modalities you have studied in-depth, or traditions you align with:
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Do you have an injuries, physical conditions, or mental illness that you feel might limit your full participation in the course? (This information is confidential and will help us to better serve you).
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How did you hear about this course?
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Do you have a promo code for this course?
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How do you intend to pay for this course?
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Pay in Full
12-month Payment Plan
Other:
What payment method do you plan to use?
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Venmo
Cash App
Zelle
PayPal
Credit Card (**subject to additional 3% transaction fee)
Stripe Recurring Billing (Payment Plans Only)
Have you paid your application deposit? If so, what method did you use (or plan to use)?
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Venmo (@evolutionary-ed)
Cash App ($evolutionaryed)
Zelle (
evolutionary.ed@gmail.com
)
PayPal (
evolutionary.ed@gmail.com
) (manually or via the "Pay Deposit" button)
Credit Card (PayPal) via the "Pay Deposit" button
Is there anything else you would like for us to know in considering your application?
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