Vinyasa Flow Yoga Teacher Training and Certification
with Stephanie Keach
5 Days, 4 Nights
Application :

Name
Address
Phone
E-mail
Payment	Tuition does not include books, food or lodging. Space is limited, register early! $175 deposit required, details and syllabus sent upon receipt of registration. ____ $595 in full ____ $175 deposit, balance due in full at start of program
What is your gender, current age and state of health?
What is your profession?
Do you have any injuries? Please describe.
Are you currently on any medications, if so which ones and what for?
Describe your yoga experience, including teaching experience and current classes taught if applicable.
What is your intention for taking this program?
How do you plan to make the time for studying and practicing your Yoga?
What are your biggest challenges in life? And in Teaching if applicable?
Do you currently see a therapist?
How will you meet the financial requirements?
Anything else you want to tell me? Questions, comments or concerns.

Please include all information requested above with the possible exception of e-mail address. Please note by filling out this application it does not guarantee your acceptance to the program. Your application will not be processed until payment is received. Submit payment and information to Yoga South, in person or via postal mail, to address below. You will receive in detailed registration information shortly after it is received.

Yoga South
9301-A Monroe Road,
Charlotte, NC 28270
(704) 847-4950 yogasouthnc@aol.com
yoga-south.com