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aerial-vinyasa APPLICATION

250-Hour Aerial-Vinyasa Teacher Training / Summer Intensive 2017

*Application fee is non-refundable. $500 deposit is due upon acceptance to reserve your spot.

Pay $20 Application Fee

Contact Information

First Name

Last Name

Address

City

State

Zip Code

Country

Primary Phone

Additional Phone

Email Address

Emergency Contact

Name

Relationship to Applicant

Contact Phone

Medical History

Overall Health (Your answers will not limit your acceptance and will remain completely confidential)

Excellent

Good

Fair

Under Par

Other

Please tell us more about any past or present medical conditions or physical injuries.

Do you suffer from any of the following contraindications for inversions? (Check all that apply)

Bone weakness, recent fracture, skeletal implants

Glaucoma

Heart/ circulatory disorders

Hiatal hernia, ventral hernia

High blood pressure, hypertension

Middle ear infection

Obesity (extreme)

Retinal detachment

Spinal injury/recent trauma to the spine

Stroke/Transient ischemic attack

Yoga Study

All applicants must have a consistent yoga practice of at least 1 year. How long have you been practicing yoga?

What style(s) of yoga have you practiced in the past?

What style(s) of yoga do you currently practice?

How often do you typically practice per week?

Which teachers have primarily influenced your practice (Om Factory staff and others)?

Do you have a current self practice and if so, how frequently do you practice on your own?

Meditation Practice:

Daily

Fairly often

Rarely

Never

Pranayama Practice:

Daily

Fairly often

Rarely

Never

Have you ever participated in a yoga teacher training program before? If yes, please provide details.

Are you currently teaching yoga? If yes, please explain teaching history:

Any additional studies past or present related to yoga (ex. qigong, acrobatics, health care, acupuncture, theology)?

Aerial Yoga Study

Please complete each of the following questions thoughtfully, thoroughly, and to the best of your abiliyt. Have you ever take an aerial yoga class at Om Factory?

Have you take an Aerial yoga class anywhere else?

How often do you practice Aerial Yoga?

Why do you want to teach Aerial Yoga?

Yoga Discussion

Why are you interested in teacher training?

What are your expectations of the program?

Please explain any physical or mental challenges you are looking to benefit from the program?

What do you think makes a good yoga teacher?

Any other personal goals for the program you wish to relate?

Additional Information

How did you hear about our Teacher Training Program?

Do you have any questions, comments, or concerns?

Applicant Agreement

* I understand and agree to fulfill all the requirements of Om Factory Yoga School, including in-class hours, homework, and non-contact hours outside of the classroom. I will receive a diploma of certification upon completion of all requirements and consent of lead instructors that can then be submitted to Yoga Alliance for 200-hour registration. I understand that Om Factory reserves the right to ask me to leave the program if my behavior is unethical, inappropriate, or in anyway violates the Yoga Alliance or Om Factory School of Yoga’s ethical guidelines. Under such circumstances, I will not be refunded my tuition. I understand that all Om Factory School of Yoga materials cannot be reproduced by me without permission of the author. Failure to comply may result in legal action. I have read and accept all above terms and requirements

Applicants who have been accepted will be notified by email. Please let us know here if you would rather be notified by phone. Applicants who have been accepted into the program must confirm participation immediately via e-mail or by return phone call to the person who notifies them. If an applicant fails to confirm participation and preferred method of payment by September 12, 2018, another student may fill that space. Please indicate your preferred method of notification:

By Email

By Phone

By submitting this application you acknowledge that you have answered the questions truthfully and to the best of your ability.