INQUIRY FORM

NOTICE: Completing and submitting this on-line International New Studio Contact Information form does not mean you are or will be qualified, authorized or approved to purchase and open a Bikram Yoga franchised studio. The submission of this form does not grant you any rights to the use of the Bikram trademarks or copyrights.

PERSONAL CONTACT INFO

Name:*

Address:*

City:*

zip / postal code:*

Country:

State:*

Phone:*

e-mail:*

Are you a Bikram Yoga Certified Teacher?*

Yes No

Date of Bikram Teacher Training Graduation (mth. / yr.):

Date of Bikram Teacher Re-Certification
(if applicable) (mth. / yr.):

Location requested for your
new Franchise School:*

Zip (Location Requested):*

EXISTING AFFILIATED BIKRAM SCHOOL
Name of school:
School address:
City:
zip / postal code:
Country:
State:
School phone:
School e-mail:
School website:
Date of original opening:	(mm/dd/yyyy)
Opening date at current location:	(mm/dd/yyyy)
Expiration date of current Bikram Yoga College of India Affiliation Agreement:	(mm/dd/yyyy)
Date lease of current location expires:	(mm/dd/yyyy)
Does current lease have options to extend?	Yes No
If so, what would be ultimateend date of lease if options to extend were exercised?	(mm/dd/yyyy)

In March of 2002 my heart beat increased to 200 beats per minute. The electrical current in my heart malfunctioned due to the scar tissue from my 1985 heart attack. My good health from practicing Bikram yoga kept me alive.
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This testimonial is the story of my personal recovery from debilitating pain from herniated discs through the practice of Bikram Yoga. This yoga gave me back my life.
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