Yogify Your Life!
Yoga Teacher Training & Retreats
Student Application Form

Course Date*
Location:*
Full Name*
First name Last name
Preferred name*
Email*
Phone Number:*
Gender*
- Male
- Female
Date of Birth (Day/ Month/ Year):*
Current occupation*
Passport Number:*
Address*
Street Address City State / Province / Region ZIP / Postal Code Country
Facebook / Instagram account name?*
How did you hear about our yoga course?*
Do you have any food allergies?*
Do you have any physical limitations/injuries that may prevent you from an extensive asana practice or for sitting for extended periods of time? If yes, please describe:*
How frequently do you practice yoga (daily, weekly, monthly)?*
Are you currently taking any form of medication?*
How long have you been practicing yoga? Please explain experience and styles of yoga explored.*
What do you hope to get out of this immersion/teacher training? Please list the 3 primary things.*
Is there anything else it would be helpful for us to know about you or your past? (e.g. social therapy, anxiety issues, etc)*
Have you got any fears or apprehensions about the upcoming training?*
At Loka Yoga we serve vegetarian food, and we encourage you to explore that diet with us. Y/N? If no, please advise us why?.*
Do you have any specific food requests? Please know that we will do our best to cater for you, but depending on the request, it may not be possible*
Have you ever received professional medical treatment due to any psychological condition?*
EMERGENCY CONTACT - Full name*
EMERGENCY CONTACT - Relationship to you*
EMERGENCY CONTACT - Email address*
EMERGENCY CONTACT - Contact phone number (please include country code)*
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Yogify Your Life! Yoga Teacher Training & Retreats Student Application Form

Copyright 2020 Loka Yoga School

Yogify Your Life!
Yoga Teacher Training & Retreats
Student Application Form