The Science of Yin Yoga Teacher Training 60 hr Certification Progam
Yin Yoga Teacher Training Level 1: Foundations Application
Thank you for your interest in Yin Yoga Teacher Training program with Monica Angelatos. Please complete the following application form, and submit your non-refundable $300 deposit. Once your application has been reviewed you will be notified of your acceptance status. Please return this form as soon as possible to guarantee your place in the program, as enrolment is limited to both a minimum and maximum.
NOTE: in the case that your application denied your deposit will be returned.
Scan and email completed application to: firstname.lastname@example.org
I am applying for the Yin Yoga 60 hour program beginning: (date)_________________________________________________
NAME: _________________________________________________________________________ AGE: __________________
MAILING ADDRESS: _____________________________________________________________________________________
______________________________________________________________________________________ City, Province, Postal Code
HOME PH: ( )_________________________WORK PH: ( )_______________________CELL:( )___________________________
E-MAIL ADDRESS: _______________________________________________________________________________________
PREREQUISITE INFORMATION (If an answer is no, please explain)
Do you have a high school diploma or equivalent? YES____ NO____
Do you have any post secondary education? YES____ NO____
If YES, what is the name of your educational institution, and did you receive a diploma? ______________________________________________________________________________________________________
Regular Yoga Practice for at least 1 year? YES___NO___
Number of years practicing Yoga ___
How frequent is your current practice? Daily__, 6x/wk__, 4-5x/wk___, 2-3x/wk___
What length of time do you regularly practice? 1⁄2Hr__, 1Hr__, 1.5Hrs__, 2 Hrs(+) __ Regular Classes for at least 6 months? YES ____ NO_____
Teacher’s Name: _______________________ Yoga Style/Tradition: ____________________ Do you have a regular meditation practice? YES____ NO_____
If yes, what type/tradition of meditation do you practice? ________________________________________________________
PAST YOGA EXPERIENCE, STYLES OR TRADITIONS: ______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
CURRENT YOGA TEACHING EXPERIENCE:
Are you currently teaching yoga? If yes, how many classes per week: ___________________ What tradition/style? ___________________ Duration of each class? ____________________
Under medical treatment or supervision for: __________________________________________________________________ __________________________________________________________________ Pregnant: __________ Due date: ________ Comments: ____________________________________________________________________________________________
Chronic Physical Limitations/ Physical Disabilities (e.g., vision, hearing, movement, etc.) Nature & Extent of Limitation ____________________________________________________________________________________________________________________________________________________________________________________________________________
Serious illness or major surgeries within the last 5 years (e.g., heart problems, cancer,
etc.) Conditions and Dates: ____________________________________________________________________________________________________________________________________________________________________________________________________________
Communicable Diseases: _________________________________________________________________________________
Drug or Alcohol Addictions: _______________________________________________________________________________
Prescription Medications (indicate dosage and frequency of intake): _______________________________________________ ______________________________________________________________________________________________________
Presence of pins, plates, rods or internal wires:________________________________________________________________
EMERGENCY CONTACTS: In case of emergency please contact:
Name: ____________________________________________________ Phone: _____________________________________ Physician: _________________________________________________ Phone: _____________________________________
How did you find out about the Yin Yoga Teacher Training program with Monica? ____________________________________________________________________________________________________________________________________________________________________________________________________________
Please attach a brief letter detailing why you wish to be a Yin Yoga Teacher, how Yoga has Impacted your life, and what you hope to receive from a program such as the Science of Yin Yoga Teacher Training 60hour program. Please limit your letter to one page at the most if possible. This letter must accompany your deposit and application form for your application to be complete.
This course is intended to result in your certification, which qualified you to teach Yin Yoga. Your name will be listed on Monica’s Website upon completion.
Certified Yoga Teachers from the program must possess the skills and abilities necessary to safely and competently teach both Yin Yoga.
The right is reserved to withhold certification from any student who fails to develop the skills necessary to teach Yin Yoga competently and safely as outlined in the teaching program.
Every attempt will be made to provide input throughout the program about teaching deficits that might impede certification. You will receive 40 contact hours with your program instructor with evaluation on your performance, quizzes and assignments. Your instructor will be available for you to share your questions and concerns about becoming a Yin Yoga teacher.
1. Practice Teaching:
Full participation in all practice-teaching sessions is mandatory for certification. During these sessions you must demonstrate an ability to teach Yin Yoga safely and competently, using the methodology presented in the training. Certification is contingent upon these criteria, as determined by the subjective evaluation of the Program Instructors. During your at home teaching practicum, you are required to teach eight classes of 1.5 hours in duration each. You are to provide documentation of your class outline, journal notes following each teaching session, and evaluation forms completed by your “students” at the end of your practicum. These will be due at your following module, and evaluation forms will be provided through the program. There are absolutely no exceptions to this requirement.
We encourage 100% attendance at all sessions. If a session is to be missed, the student should inform the instructors in advance where possible. Reasons for missing must be reasonable and could include medical concerns, family emergencies, and irresolvable work conflicts. The student teacher will be required to make up the time lost at another yoga program at the student teacher’s own expense.
Throughout this course, students will occasionally be required to take practical and written tests or quizzes on the material. Students who receive less then 70% on any given test will be required to re-take the test at the discretion of the instructors. Assignments will be issued at the end of each module and will be expected by the first day of the following module. Each practice teaching session will be evaluated and is considered a part of the testing modality.
4. Professional Behaviour and Ethical Conduct:
Student in the program are required to behave in an ethical manner to help create safety and respect while maintaining a professional atmosphere. This includes an appropriate wardrobe,
5. Continuing Education:
Being a Yoga teacher is a lifelong journey, and it is recommended that students maintain at least 25 hours of continued Yoga study/training every two years in order to continue to expand their knowledge and skill as an instructor. This information is to be recorded and tracked by the individual Yoga teacher on the “honor system” and they should be verifiable documentation at any time as proof of meeting this requirement. We also strongly suggest obtaining and maintaining valid CPR and First Aid training.
A non-refundable deposit of $300.00 is required at the time the application is submitted. Should you be unable to participate in the full program, your refund will be pro-rated based on which modules you have participated in to date. This will be on a case-by-case basis. If accepted to the program and unable to participate, full tuition will be refunded, minus the deposit. Notice must be received no later than 30 days prior to the program beginning.
I have read and understand all the above criteria for certification as a Yin Yoga Teacher from the 2016 Yin Yoga Teacher Training 60 hour program. I agree to meet all ethical and continuing education requirements outlined in this document. I agree to inform the instructor should my health status change, and I take full responsibility for my own physical health during my time in the program and its practices.
NAME (please print): ___________________________________________________________________________