Home Teacher Training On-line Application

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         
  Weight : * Pound     
  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 ($12,500.00) Single ($16,600.00)  
  If you need extra nights before training please fill in the following fields. For any questions regarding extra nights email accommodations@bikramyoga.com  
  Date of Arrival: (mm/dd/yyyy)  
  Arrival Time:  
  Airline Name:  
  Flight Number:  
  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.

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.

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