500 Hour Teacher Training Application Samadhi Yoga Student Application-500 Hour Program Thank you for exploring this path and for your connection with Samadhi’s 500 Hour Yoga Teacher Training Program. Please take some time to answer the following questions to assist us in our efforts to get to know you better! Personal Information Name* First Last Email* Phone Number* Address* Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code What is your current occupation?* Which program are you applying for?* 500 Hour Teacher Training200 Hour Teacher Training100 Hour Yoga Immersion Emergency Contact Information Name* First Last Email Phone Number* Relationship to You* About You First, tell us a little about who you are generally, what you are passionate about, and some nuts and bolts about your family, work life, and sense of purpose. Current Age* Please describe your “edge” in the practice of yoga and life. Where do you get stuck?* Please note some of your inner strengths, upon which you can always rely?* Personal Photo* Please attach a photo of yourself when you send in this application. About Your Interest Our Program What do you hope to learn and experience in this program? Please describe your expectations.* Is there an aspect of yoga practice/teaching that is particularly fascinating to you? Please explain.* Are you committed to finishing the full 500 hour training with us or are you planning to take only a few modules or electives?* About Your Yoga What is your yoga background? How long, what types, where, and with whom have you practiced? Please make your information as specific as possible.* What does your current yoga practice look like?* Do you currently teach yoga? Do you intend to teach in the future?* How long have you been teaching? Please describe the styles, places, and frequency of your teaching practice.* Do you have a meditation practice? If so, please describe.* How would you describe your orientation to the teachings of yoga and/or dharma? How is this expressed in your classes and in your life?* About Your Goals Why do you want to become a 500-hour level certified yoga teacher?* What are some additional goals that you have for yourself and your path?* About Your Previous Training Please list details of any previous yoga training in which you have participated.* If this doesn’t apply to you, just enter “Does not apply.” Please list any additional training, certifications, degrees you have received (i.e. college de-grees, massage, nursing, etc.). Also mention the institutions from which these credentials came.* If this doesn’t apply to you, just enter “Does not apply.” About Your Current Health How would you evaluate your current health?* Excellent Good Fair Some Challenge Are you currently, or during the last two years have you been, under the care of a physician or other health care professional for any reason?* Yes No If your answer is Yes, for what reason?* Do you have any injuries, chronic or acute? If your answer is Yes, please describe. Anything else? What else would you like to share with us?