Registration Form
for the Yoga Teachers Training Course
500 Hour Level

This application is only for Students who have 200 Hour Certification from an accredited Yoga Alliance School.

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

Limitations or disabilities if so please explain:

 

Yoga Experiences:
Years Studied Yoga:___________________ Where:_______________________________
Where have you taken the 200 hour course?________________________________________
Are you presently Teaching Yoga?________ Number of Years Teaching Yoga?__________
Certifications:______________________________________________________________


Enclosed is $____________, non refundable fee for 12 Months
beginning _________, 200_ to ________, 200__.
I herby commit to participate in, and complete, the Yoga Teachers Training Program, and fulfill all requirements, including meticulous record keeping. 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 (631) 543-7490 (718) 738-8001