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Application for Bikram Yoga Teacher Training

 
* indicates Required Information
 
 
Training Session:
*First Name:
Middle Name:
*Last Name:
*Address:
Apartment:
*City:
*State:
*Postal Zip Code:
*Country:
Country Not Listed:
State Not Listed:
*Cellular or other primary Phone:
*Occupation:
*E-Mail:
(you must be 21 years of age to attend teacher training)
  *Date of Birth:
 *Height:  
 
*Weight:  
 
*Gender:  Male:  Female:
*Eye Color:
*Emergency Contact Name:
*Emergency Telephone Number:
*Emergency relationship:
 
 
 

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*How would you rate your general level of fitness
(i.e. cardiovascular capacity, flexibility, and strength)?:
Excellent  Good   Fair   Poor
*How would you rate your overall health?:
Excellent  Good   Fair   Poor
*How long have you practiced Bikram Yoga?:
*Which certified Bikram studios/teachers
have you studied under and for how long?:
*How many times a week do you practice Bikram Yoga?:
*Have you ever practiced Bikram Yoga for 30 continuous days?:
Yes   No
If yes, how many times and when?:
Have you ever practiced other methods of yoga, and if so which?:
How Long?:
 
   Where?:
 
Are you certified to teach other methods of yoga, and if so which?:
What other exercise/sports do you practice and how often?:

 

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    * Are you capable of:

  1. taking two (2) Bikram Yoga classes a day (comprising in total from three (3)to five (5) hours of yoga per day, six days a week, for nine (9) weeks;

  2. attending lectures and clinics for an additional approximately six (6) hours per day;

    3. and

  3. studying an additional approximately one to two hours per day on your own?:

  Yes  No  Not Sure
*Are you able to study and memorize written material?:
Yes   No
*Level of education:
   
*Have you ever been convicted or placed on probation for any crime or offense, either felony or misdemeanor, by any federal or state jurisdiction?: Yes   No
If yes, list each separate offense by date of conviction, offense, court of jurisdiction, and disposition (amount fined, term of probation, jail or prison, date released).
*Do you currently consume alcohol?:  Yes No
If yes, how often?
T-Shirt size (for a group T-Shirt):
*List any medical conditions you have and all medications,
prescription and non-prescription, that you take:
*Why do you want to become a Bikram Certified Teacher?
Please be as complete as possible:

Before submitting, print a hard-copy sign and date it and add it to your materials sent over to Shelly

Signature: X___________________________________________  Date: ___________________

If you have additional questions, please email shelly@bikramyoga.com