SRI LANKA

TDK DESIGN RETREAT - REGISTER YOUR INTEREST

Name

First Name

Last Name

Email Address

Date of Birth

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone

(###)

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Emergency Contact + Phone Number

Relationship to you

Please provide details of your educational background i.e. prior study, qualifications, dates & universities attended etc.

Please provide a brief description of your yoga practice including how often you practice, how long you have been practicing, what style/s of yoga have you trained in and the name of your teachers

What your intentions are for the H.E.L.P Yoga Teacher Training Course?

Why do you wish to become a yoga teacher

If you are not looking to teach after your training, what has motivated you to join a teacher training?

Please list any medical conditions, physical injuries or special requirements we need to be aware of and that you may need to consider in order to part take in this course

Do you have any learning disabilities that you wish to disclose?

Are you Pregnant? If so, how far along are you?

Please provide any other relevant additional information that will assist in your application:

How did you hear about the H.E.L.P Yoga Teacher Training Course?