Apply to Our Program

Please fill out the application below in its entirety. A non-refundable $25 application fee will be collected at the end of the form. You may mail a check instead of paying online – just select the appropriate option at the end of the application.

You will be contacted within 2 weeks to schedule an interview with Terry Brown and/or Valerie Kiser.

Name(Required)

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Address(Required)

Street Address Address Line 2 City State ZIP Code

Phone (cell)(Required)

Phone (other)

Date of Birth (optional)

Email(Required)

Enter Email Confirm Email

Emergency Contact Name(Required)

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Emergency Contact Phone(Required)

How did you find out about this program?(Required)

How long have you been practicing yoga at home? [A minimum of 1 year of personal practice is required before being admitted to the program.](Required)

Describe your home practice (yoga asana, meditation, pranayama, chanting, etc.). We will discuss this further during the interview.(Required)

Do you attend / have you attended classes? If so, how long?(Required)

Who is your primary teacher(s)?(Required)

What style or lineage of yoga do you practice and/or teach?(Required)

When and where did you complete a 200-hour Teacher Training Program? [We require that you have completed a 200-hour yoga teacher training program that is a Registered Yoga School (RYS) with Yoga Alliance or a program that meets the same competencies which include integration of these categories: Yoga techniques, anatomy and physiology (Western and Eastern), yoga philosophy foundations, teaching methodology, and practicum (practice teaching).](Required)

Please provide a copy of your certificate of completion.

Max. file size: 128 MB.

List your yoga-related education beyond the 200-hour training such as workshops, conferences, retreats, etc.(Required)

List any yoga teaching experience you have including dates, location, level of classes, and style. [A minimum of 1 year of teaching is required before being admitted to the program.](Required)

List other related modalities that you have studied including dates and locations (e.g., physical therapy, Ayurveda, etc.)(Required)

Please list information for 2 persons who can verify your yoga experience as a student and as a teacher.(Required)

Name

Phone

Why are you interested in a Yoga Therapy training program?(Required)

What is your understanding of the difference of a yoga teacher and a Yoga Therapist?(Required)

How do you plan to use your yoga therapist training in practice?(Required)

Date(Required)

Application Fee

Application Fee Total

Upon submission you will be redirected to PayPal where you can pay by debit/credit card or your PayPal account.

This field is for validation purposes and should be left unchanged.

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Apply Online or by Mail

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Non-refundable Application Fee = $25

Pay Online