Gertrude Street Yoga 200hr Teacher Training Application Form Your First Name (required) Your Last Name (required) Your Preferred Name Spelling for your Certificate (required) Date of Birth (required) Your Email (required) Your Address (required) Gender Male Female Emergency Contact Full Name (required) Emergency Contact's Email (required) Emergency Contact's Phone Number (required) What is your profession? (required) How did you hear about Gertrude Street Yoga's Teacher Training? (required) If you were referred by someone please list their name. What are you drawn to about this training? What made you choose this training? (required) How were you first introduced to yoga? (required) What styles of yoga have you practiced? (required) When did you start practicing yoga? (required) Please name two teachers or studios you have practiced with. (required) How would you describe your current Yoga practice? Does your practice include Meditation, Pranayama, or Mantra? (required) Please list your education and any previous trainings, even those not yoga related. (required) What is your main motivation for completing this training? Do you want to teach yoga? (required) Please share something about yourself that is unique: a skill, fact, story, or anything else you like. (required) Describe a situation in which you had to overcome a challenge or difficulty. (required) Do you have any ongoing physical or emotional health conditions that could affect your training? (required) Do you have any medical conditions that may require immediate attention during any part of the training? (required) Are you allergic to any foods? Do you have any other allergies we need to be aware of? (required) Are you currently taking any medications? If so which ones? (required) What is your level of oral and written proficiency in english? (required) Agreements* I understand that 1+ year of experience practicing yoga is recommended before attending this training I understand that once my application has been accepted my deposit is non refundable understand once I have been accepted my deposit is non refundable I understand that I must make my deposit and attach proof before my application will be processed I understand that missing more than 3 days may result in loss of certification I have read and agree to the cancellation policy I will complete the required reading Pricing* $4,500 before 1 February, 2017 $4,800 after 1 February, 2017 I am currently a Gertrude Street Yoga Studio Member I am applying for a $500 scholarship If you are applying for a scholarship please share what receiving the scholarship would mean for you Pay your deposit by clicking the link above. A window will open and you will be directed to log into your Mindbody Account with us. If you don't have one you can create one. Once you have logged in you will be able to pay your $500 deposit securely. Attach proof of your payment* Attach a headshot* Cancellation Policy 30+ days before course start date: 100% refund (minus the $500 deposit) 20-30 days before the course start date: 50% refund (minus $500 deposit) 10-20 days before the course start date: 25% refund (minus $500 deposit) 0 – 10 days before the course start date: No refund If for some reason you are unable to complete the course once you have started we will find the best course of action on a case by case basis. Sign below with the mouse or your finger to complete your application. Once you have clicked “apply” please wait a few seconds until you see the confirmation message appear.