DECLARATION OF INTEREST

to the Yoga Therapist Training Program

With the first year of our 1,008-hour Yoga Therapist Training online, the program includes 11 in-person modules totaling 458.26 residential hours, 369.74 distance learning hours (329.74 synchronous, 40 asynchronous), and 180 asynchronous practicum hours.

Please provide your contact details and answer the questions below, then confirm your declaration of interest.

Please note, you cannot save progress and return to this form later. You must be able to complete this form in one sitting.

If you need more time to compile your answers consider writing them in a separate, saved document, and then copy and paste them into this form when you’re ready to submit. You can copy the link above and return to this page later if needed. Your declaration of interest will not be processed until you complete this portion.

Contact Information
Name*
First Last
Preferred Name (if different)
Email*
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Profile
Date of birth*
Month
Day
Year
If you have a website, please provide it.
What is your primary occupation?*
Do you plan to apply for financial assistance or scholarship opportunities through the Yoga Well Institute for this program?*
Yoga Therapy Foundations
Why are you interested in becoming a Yoga Therapist?*
Why are you interested in the Yoga Well Institute’s Yoga Therapist Training?*
What do you hope will result from participating in this Program, both personally and professionally?*
Teaching and Training
What is your background in and experience with Yoga and meditation?*
If you have certifications or training in other medical or healing arts, briefly describe them.*
Briefly describe the Yoga classes you teach or have taught.
Mentor Experience
Do you have a mentor?*
If you have a mentor please give your Mentor’s name and describe your experience working with them.
If not, are you open to being guided in your yoga practice and yoga teaching by a Mentor?
What do you currently work on, or would you want to work on, with a Mentor?*
Declaration*
I agree to the declaration.
I declare my active interest in pursuing application to the Yoga Well Therapist Training Program.
I have carefully read the Program Guide and I am in agreement with the general rules and policies of the same.
I understand and accept that the Yoga Well can change or modify any of its policies without prior notification, during the tenure of the course, and even afterwards.
I declare that all the information provided in this Declaration of Interest is true and accurate at the time of completion.
I agree that I will accept the decision of the Yoga Well in accepting or rejecting my application.

DECLARATION OF INTEREST

to the Yoga Therapist Training Program

Please provide your contact details and answer the questions below, then confirm your declaration of interest.

Contact Information

Profile

Yoga Therapy Foundations

Teaching and Training

Mentor Experience