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SYS 500 Hr Teacher Training Agreement
Thank you for your interest in Source Yoga Studios 500 Hour Teacher Training Program. Please complete the following application form, and enclose your non-refundable $100.00 registration fee, made payable to Source Yoga Studios. Once we have reviewed your application and received a copy of your 200 HR Certification Certificate, we will notify you of your acceptance status. Please return this form as soon as possible to guarantee your place in the program.
Return completed application electronically or by mail to:
Dillon Cherrett
Source Yoga Studios
2567 Pembina Hwy.
Winnipeg, MB
R3T2H5
I am applying for the 500 HR Source Yoga Teacher Training Program beginning (todays date)
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Name
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First
Last
Address
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Street Address
Address Line 2
City
State / Province / Region
Postal / Zip Code
Antigua and Barbuda
Aruba
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Belize
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China
East Timor
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India
Indonesia
Iran
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Israel
Japan
Jordan
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North Korea
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Kuwait
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Laos
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Maldives
Mongolia
Nepal
Oman
Pakistan
Palestine
Philippines
Qatar
Russia
Saudi Arabia
Singapore
Sri Lanka
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Nauru
New Zealand
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Samoa
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Tonga
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Algeria
Angola
Benin
Botswana
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Burundi
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Chad
Comoros
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Republic of the Congo
Djibouti
Egypt
Equatorial Guinea
Eritrea
Ethiopia
Gabon
Gambia
Ghana
Gibraltar
Guinea
Guinea-Bissau
Cote d'Ivoire
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Lesotho
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Libya
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Mali
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Mauritius
Morocco
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Namibia
Niger
Nigeria
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Sao Tome and Principe
Senegal
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Somalia
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Sudan
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United Republic of Tanzania
Togo
Tunisia
Uganda
Zambia
Zimbabwe
Country / Region
Phone
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Email
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In case of emergency please contact:
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Phone
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How many years have you practiced yoga?
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Do you have a regular yoga practice?
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Yes
No
How frequent is your current practice?
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Daily
4-5x/wk
2-3x/wk
Current Teacher's Name:
Yoga Style/Tradition Practiced:
Do you have a regular meditation practice?
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Yes
No
Past Yoga Experience, Styles or Traditions
How did you find out about Source Yoga Studio's teacher training program?
Refund Policy
$100.00 application fee is non-refundable.
Each module is registered for and paid for at the time of registration. Modules are non-refundable, but are transferable. If you are unable to attend a module, you may transfer the fee for that module to another module.
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Agree
Disagree
I have read and understand all the above criteria for certification as a Yoga Teacher through the Source Yoga Teacher Training program.
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Yes
No
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