Application for 200-Hour Teacher Training Modules 2023

Step 1 of 3

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I am applying for*

Module 1: Yoga Immersion Program

Module 2: Yoga Teaching Essentials

Both Modules 1 and 2

Personal Information

Name*

First Last

How would you like to be known in class?*

Preferred name, nickname, or spiritual name Pronouns

Email*

Phone*

Home Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

My Home and Mailing addresses are the same*

Yes

Mailing Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Age*

Occupation*

How did you find out about this program? Check all that apply.*

IYI Website

IYI Newsletter

Facebook

Instagram

Internet Search

Yoga Alliance

Yogaville

IYI San Francisco

Integral Yoga Teachers Association (IYTA)

Other

Your Yoga Experience

How long have you practiced yoga?*

Where have you practiced over the previous 6 months?*

How frequently do you take classes?*

Have you taken at least 3 (or more) classes with Integral Yoga?*

Yes

How long have you practiced Integral Yoga?*

When do you intend to begin taking Integral Yoga classes?*

Have you practiced other styles of Yoga?*

Yes

What other styles of Yoga have you practiced?*

Do you practice meditation?*

Yes

What method or style of meditation do you practice? When did you start practicing meditation, and how frequently do you practice?*

Have you been involved in any capacity with Integral Yoga or with Satchidananda Ashram? Have you taken any Integral Yoga retreats, workshops, or other programs?*

Yes

Have you ever served as a Karma Yoga volunteer for Integral Yoga?*

Yes

Please describe your Karma Yoga activities. What did you do and how long were you an active volunteer?*

Personal Essay*

Please briefly describe your personal and occupational background, as well as the spiritual background that may have influenced you to apply for this program. Please indicate your special talents and skills, and anything else that you would like us to know.

Scholarship

Partial scholarships may be available when possible. If you would like to be considered for a scholarship, please indicate the basis for your request.

BIPOC

LGBTQ+

Other

If you selected "other" above, please specify.

Is there anything else you'd like for us to take under consideration in reviewing your request for a scholarship?

Health and Safety Information

Do you have any injury, illness, physical or mental health conditions that may impact your participation in the training?*

Yes

Please describe how it may impact your participation in the training.*

Are there any other issues or concerns that you would like the instructors to be aware of?*

Yes

Please share issues or concerns*

Emergency Contact Information

Emergency Contact Name*

First Last

Emergency Contact Methods*

Phone

Phone & Email

Emergency Contact Phone*

Emergency Contact Email*

References

Please provide us with two references we may contact. The references you provide should be professional (e.g. supervisors, employers, co-workers, teachers, etc.) not family members or friends.

Reference 1 – Name*

First Last

Reference 1 – Relationship*

Reference 1 – Phone*

Reference 1 – Email*

Reference 2 – Name*

First Last

Reference 2 – Relationship*

Reference 2 – Phone*

Reference 2 – Email*

Tuition

Tuition Policy*

TUITION
Tuition includes a non-refundable deposit of $250 to reserve your space within the training. Applications must be accompanied by a tuition payment of at least the minimum deposit amount. Applications will be not be reviewed until the deposit payment is received.

Upon acceptance into the program, the balance of tuition will be due.

For Module 1: Yoga Immersion Program
• $1,050 early bird discount, register by June 10.
• $1,250 full rate after the early bird deadline.

For Module 2: Yoga Teaching Essentials
• $1,850 early bird discount when registering for Module 1 and 2 together.
• $2,000 full rate.

I have read and agree to the tuition policy.

Select payment method for application deposit:

Credit or Debit Card

Paypal

Zelle

Application Fee*

Price:

Credit Card

Card Details

Cardholder Name

After submitting this application send your $250 application fee via PayPal to TeacherTraining@iyiny.org.
Please include your name and the training you are applying for with your payment.

After submitting this application send your $250 application fee via Zelle to Gopala@iyiny.org.
Please include your name and the training you are applying for with your payment.

Payment Plan*

Tuition payment in full is due before the training begins. A payment plan option is available to continue payments over the course of the training, with a nominal administrative fee to enroll in the payment plan. On the payment plan, your tuition will be divided into monthly installments. The first installment may be initiated at applicant’s earliest convenience, and is due before the training begins. Subsequent installments will be processed every 30 days following initial payment.

Please note: complete payment of tuition is a requirement for graduation and certification. Late payments are given a one-week grace period. Excessively late payments may result in the student being asked to discontinue coming to class until the balance due is resolved. If you experience unexpected financial difficulty during the training, please contact the administrator to discuss your options.

Yes, I wish to enroll in the payment plan. I acknowledge the terms of the plan and late payment policy.

No. I prefer to pay the balance of tuition before the training begins.

Admission and Continuation Policy*

Please read the full Admission, Probation, and Continuation Policy provided on our website. Acceptance into the training program is not guaranteed, and is conditional upon the applicant meeting the basic requirements as stated in the training prerequisites. A completed application form, deposit, and admission interview are required to be considered for acceptance. During the interview, the trainers and applicant together will assess whether the training is the appropriate program for the individual, if it is the right time for participation, and whether successful completion can be expected. If an applicant is not accepted into the program, $200 of the deposit will be refunded.

After the training begins, any refund of tuition is contingent upon several factors including: length of time in the program, reason for withdrawal or dismissal, return of training materials, intention to complete the training at a later date. Applicants acknowledge that refunds after the training begins are not guaranteed, and will be issued in accordance with the Admission and Continuation Policy as stated on the website.

I agree to the Admission and Continuation Policy

Photo and Video Release*

I acknowledge that by participating in an online program I may appear in photos or video recordings of the training. I grant to Integral Yoga Institute of New York and its representatives the right to take photographs/video/recordings of me and my property. I authorize Integral Yoga Institute, its assigns and transferees to copyright, use and publish the same in print and/or electronically.

I agree to the Photo and Video Release

General Enrollment Agreement

I wish to apply as a Teacher Trainee, and I agree to assume full responsibility for any injuries to me that may occur during the training. I am in good health, and any physical illnesses or ailments are clearly stated above. I have read and agree to abide by the policies for admission and continuation of the training program. I acknowledge agreement to fulfill all my teacher training requirements to meet Integral Yoga Institute and Yoga Alliance standards in order to receive my certification. I further acknowledge that Integral Yoga Institute reserves the right to withhold certification should my efforts not meet its requirements and standards.

I agree to the terms of the General Enrollment Agreement

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