Etowah Valley Yoga Teacher Training Application
Application Form
Name___________________________________________________________________
Address_________________________________________________________________
City_________________State______________________Zip______________________
Phone cell___________________home__________________Work_________________
E-mail Address______________________________Fax#_________________________
Medical Information
Any ailments or physical limitations?__________________________________________
Back or neck concerns?____________________________________________________
Hip or Knee problems?_____________________________________________________
Surgery within Last year?___________________________________________________
Rx medications?__________________________________________________________
Are you pregnant?_________________________________________________________
Do you currently follow any exercise program?__________________________________
Interest and Experience in Yoga
How long have you been practicing yoga?______________________________________
What is your current Yoga experience?________________________________________
________________________________________________________________________
________________________________________________________________________
What styles of yoga have you been taught or trained in?___________________________
________________________________________________________________________
________________________________________________________________________
Do you plan to teach yoga or are you taking this course to improve your personal
practice?________________________________________________________________
________________________________________________________________________
_______________________________________________________________________
Any Additional Comments__________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
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Signature______________________________________Date_______________________