The next training session begins on April 1, admissions will close on March 28, 2022. "*" indicates required fields Name* First Last Preferred Pronouns Email* Phone*Home Address Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Is your mailing address different than your home address?*We will be mailing you your course materials Yes No Mailing Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country UntitledUnder 12 years old12-17 years old18-24 years old25-34 years old35-44 years old45-54 years old55-64 years old65-74 years old75 years or olderOccupation* Interests, skills, hobbies* How did you find out about this program? Check all that apply. * IYINY Website IYINY Newsletter Facebook Instagram Internet Search Yoga Alliance Yogaville IYI San Francisco Integral Yoga Teachers Association (IYTA) Other Untitled Other way you heard about this program Yoga ExperienceWhen and where did you complete your 200-hour yoga teacher training? ** Who were your primary 200-hour instructors? * When and where did you complete your prenatal yoga teacher training? ** Who were your primary prenatal instructors? ** What other yoga training experience have you had?* Why are you interested in taking Yoga for Labor & Birth training?* Are you following the yogic lifestyle guidelines? Untitled Yes, I teach a regular weekly class or at least two classes per month Yes, but I teach less often than twice a month No HEALTH AND SAFETY INFORMATIONThis information is requested in order to better serve both you and the Integral Yoga community. Responses will be kept confidential.Do you have any injury, illness, physical or mental health conditions that may impact your participation in the training?* Yes No Please share what 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 No Please share your other issues or concerns* Emergency Contact InformationEmergency Name First Last Emergency PhoneEmergency Email Agreement*TUITION $525 full tuition, or $475 early bird discounted tuition if you register by March 1, 2022. A payment plan is available in two monthly installments of $275, the deadline to enroll is March 1, 2022. Tuition payment must accompany your application to complete your enrollment. Full payment is due before the training begins. Non-payment will result in canceled registration from the course. * Active IYI teachers are eligible for discounted tuition of $450. Directions to complete registration with your discount will be emailed to you after your application has been received. Refund Policy: Tuition is refundable, minus a $50 administrative processing fee, up to one week before the training begins. For cancellations received less than one week before, or after the training begins, tuition is nonrefundable. All credits and returns are at the discretion of IYINY. Admission and Continuation Policy 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 and deposit are required to be considered for acceptance. Tuition must be paid in full before the training begins, or the student may not be admitted to join the class. If an applicant is not accepted into the program, tuition will be refunded less a $50 administrative processing fee. If the student decides to withdraw their application before the training begins, any balance paid beyond the $50 administrative processing fee will be returned. After the training begins, any refund of tuition is contingent upon several factors including but not limited to: 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. 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. 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 the 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 I fail to complete all requirements for certification. I agree to all of the aboveNameThis field is for validation purposes and should be left unchanged. Δ