CENTER FOR YOGA STUDIES
MENTOR PROGRAMS APPLICATION

PLEASE COMPLETE THIS APPLICATION ONLINE OR PRINT IT OUT AND FAX IT (212) 397-5865

Please share your basic contact info with us below:
Name :
Address :
Address Line 2 :
City or Town :
State/Province :
Country
Zip / Postal Code
Best Phone# to reach you
Email
Age Group
Gender
Emergency Contact Name
Emergency Contact Phone
How did you hear about our Teacher Trainings/Immersions? *RESPONSE REQUIRED

In Studio
Google
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Friend
Yoga Alliance
Other:

Please share your yoga background with us
From what School did you receive your 200 Hr Certificate?  
What date did you complete your training?         
What do you feel your main strengths as a teacher are?  
What areas of your teaching would you most like to work on?            
Please list your first, second and third choice of teaching mentor:  
Why are you drawn to these individuals as mentors?  
Do you have a regular daily practice? If so, please describe it:  
Please tell us about your health: injuries, conditions, illnesses or anything else that might impact you, your practice and prepration to teach
So, how is your mindset lately?
What are your expectations for this apprenticeship?
What do you hope to learn/work on?
 
I acknowledge the $100 processing fee and the $75/month Practicum Charge.
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