Registration Form
for the
Yoga Teachers Training Course
200 Hour Level

Name:____________________________________________________________________
Address:__________________________________________________________________
City:________________________________ State/Zip:____________________________
Home Telephone:______________________ Business Telephone:____________________
Cellular Phone:________________________ E-mail:______________________________
Occupation:___________________________ Age:_______________________________

 

Limitations or disabilities if so please explain: __________________________________________


Reason for taking the Teachers Training______________________________________________

 
Yoga Experiences: __________________________________________________________
Years Studied Yoga:___________________ Where:_______________________________
Are you currently enrolled in a yoga class?_________Where?___________________________
Are you presently Teaching Yoga?________ Number of Years Teaching Yoga?__________

Previous Teachers Training Experince:_____________________________________________

Certifications:______________________________________________________________


Enclosed is $ _______, non refundable fee for September 2010 Semester

I herby commit to participate in, and complete, the Yoga Teachers Training Program.
I understand that certification is granted upon successful comprehension and mastery of the principles and practices of yoga.
Signature:____________________________ Date:________________________________

Please make check payable to YTTI and mail with application to:
Mokshapriya Shakti 114-41 Lefferts Blvd., S. Ozone Park, NY 11420
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Yoga Teachers Training Institute (718) 738-8001 or (631) 896-2224