The Zen Yoga Studio

School of Enlightenment & Healing Arts Center

Teacher Training Application / 500 Hour: Hatha 2: Total Healing Evolution!

If you love Yoga and aspire to go deeper into asana, spiritual awareness and healing, our500hr Teacher Training is for you! Ourprogram provides the knowledge and opportunity for growth in your personal journey by providing an extension from your 200 hour program. You will go more in-depth into Asana, chanting, meditation, Pranayama and study of yogic philosophy and texts.Participants meet one weekend per month (Friday’s 6-pm & 9am -5:30pm Friday, Saturday & Sunday) for 18 months.

Note: No sessions are held in the month of December.

Tuition Information

Price $5,000

Down payment of $1,500 due with application byMarch 6th

4payments (of $875), due on April 10th, May 1st, June 5th, July 10th

Early bird pricing of $3500 for all paid in full byMarch 6th

*Deposits and payments are non-refundable and non-transferable*

Tuition include:

· Student journal,

· FREE classes at The Studio for the duration of active enrollment in the program

There is no fee for required classroom observations.

Minimum of 5 students required for training. To reserve your place in the training, submit

your application along with your deposit.

* Please email your completed application to *

Your Name ______500hr App

Payment Information

A deposit is due with your application in order to secure your space in the training. You maychoose to pay the deposit or the full payment at this time (please indicate below).

Applications and deposits (or full payment) is required no later than March 6, 2015.

I am paying cash

I am paying by check: Check#______

I am paying by credit card (please circle): MasterCard Visa Amex

Credit Card # ______Exp. Date ______

Print name as it appears on card ______CCV#______

Card Billing Address: ______

City ______State ____ Zip Code ______

My signature indicates I authorize a charge of $ ______to the card above.

Authorizing Signature: ______

Personal Information

Name ______Date ______

Street Address ______

City ______State _____ Zip Code ______

Primary Phone ______Mobile / Home / Work (circle one)

Secondary Phone ______Mobile / Home / Work (circle one)

Email ______

Referred by ______

Program Information

How did you learn about The Zen Yoga Studio School of Enlightenment & Healing Arts

Center Teacher Training program?

(Please check all that apply.)

I practice at The Bhakti Yoga Studio

Internet search

My yoga teacher recommended it (please list teacher’s name): ______

Advertisement (please list source) ______

A friend told me about it

Other______

Tell Us About Yourself

Please use as much space as you need to complete the following questions

  1. How many years have you been practicing yoga?
  1. How many days per week do you practice yoga?
  1. What style of yoga do you usually practice?
  1. At which yoga studios do you currently practice?
  1. Do you have a home practice? Yes No (circle one)
  1. What are your expectations for this training?
  1. What do you hope to achieve by the completion of the program?
  1. Do you practice meditation or Pranayama?
  1. Please list prior trainings:

Name______200hr program

  1. Are you currently teaching yoga? Yes No (circle one)

If yes, please share how long have you been teaching, where you teach and what style youteach.

  1. Why are you interested in The Zen Yoga Studio School of Enlightenment & Healing Arts Center’s Teacher Training?

Medical History

Please complete the medical history section below so that we can be responsive to any

needs you may have during training.

1. How would you evaluate your current health?

  • Excellent
  • Good
  • Fair
  • Some Challenges (briefly describe) ______

2. Do you suffer from any of the conditions below?

  • Epilepsy
  • Diabetes
  • No, I do not suffer from the above conditions

3. Are you pregnant or do you plan to become pregnant during the course of training?

  • Yes
  • No

4. Are you currently or have you been under the care of a physician or mental health care

professional within the last 2 years?

5. Please list any medications you are currently taking and their purpose that have been

prescribed by your physician or mental health care professional.

1