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Fall 2013 Los Angeles

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Application for Bikram Yoga Teacher Training

Please make sure that the printer is ready. You will need the printer to get a printed copy of the application.

Do not fill out this form if you are scholarship applicant.Please see scholarship page.
  Session No. :     
  First Name : *  
  Middle Name :     
  Last Name : *  
  Address : *  
  Apartment :     
  City : *  
  Country : *  
  State :   
 
  Zip Code : *  
  Mobile Phone : *  
  Land Phone :     
  Occupation : *  
  email : *  
  Date of birth :    (YYYY/MM/DD)  
  Gender :    Male      Female  
  Emergency Contact name : *  
  Emergency Tel No : *  
  Emergency Relationship : *  
       
       
  Height : * Feet         
Centimeters
centimeter
  
  Weight : * Pound     
Kilogram
 
  Eye color : *  
  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  
  Medical condition :* Healthy    Medicine Taken  
  List any medical conditions you have
and all medications, prescription
and non-prescription, that you take :		  
  How long have you practiced Bikram Yoga ? * [yy]   [mm]   (0 - Never Practiced)  
  Which studio you have studied ? : *
 
  How many times a week do you
practice Bikram Yoga? :		  
  Have you ever practiced
Bikram Yoga for 30 continuous days? :		 Yes   No  
  How many times and when? :  
  Have you ever practiced other
methods of yoga :		 Yes   No  
  which? :  
  How long? :  
  Where? :  
  Are you certified to teach
other methods of yoga :		 Yes   No  
  which? :  
  What other exercise / sports
do you practice and how often? :		  
       
         
  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; 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 offence either felony on
misdemeanor by any federal
or state jurisdiction : *		 Yes   No  
  List each separate offense by date of
conviction, offense by court of jurisdiction,
and disposition (amount fined, term of
probation, jail or prison, date released) :		  
  Do you currently consume alcohol?* Yes   No  
  How often? :  
  T-Shirt Size (for a group T-Shirt) :  
  Hotel Accommodation : Double ($11,400.00) Single ($15,500.00)  
  How many extra nights stay is required?:  
  Room Mate Required :  Yes    No  
  Room Mate Name :  
  Leave of absence due to pre-exiting commitment:  
  Why do you want to become a
Bikram Certified Teacher? :*		  
       
       
 
I want to become a Bikram yoga teacher because I have an intense desire to share my passion and enthusiasm for the practice with other people.I have personally experienced amazing physical healing from traumatic injuries through the practice.
more...

I have had such amazing healing and strengthening experiences (both physically and psychologically) since beginning this practice.One year later I quit smoking and began practicing Bikram yoga.
more...
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