| Are you a 200-hour certified yoga teacher? | Yes, I am a 200-hour certified yoga teacher | ||||
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| Prerequisites | |||||
| Have you been teaching Yoga for 1 year or more? (minimum 50 hours) | Yes, I have been teaching for one year (minimum 50 hours) | ||||
| HTML Block | *** Successful completion of a 200-hour Yoga teacher training from a Yoga Alliance approved school is required for participation in the Integral Yoga Therapy Program track to become a Certified Yoga Therapist. | ||||
| Home Center | Yogaville, VA | ||||
| HTML Block | A minimum of one year (minimum 50 hours) teaching Yoga is required for participation in the Integral Yoga Therapy Program track to become a Certified Yoga Therapist. | ||||
| Name | Nancy Louise Debruler Sharanya | ||||
| Age | 56-65 | ||||
| Email hidden; Javascript is required. | |||||
| Address | 1418 Evergreen Road Severn, MD 21144 United States Map It | ||||
| Phone | 44351060092 | ||||
| Best days to reach you for your interview |
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| Are you a member of the Integral Yoga Teachers Association | Yes | ||||
| Time of day? |
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| Health Information | |||||
| Do you want to achieve your RYT 500-hour designation during this program? | Yes | ||||
| Chronic Health issues? | Yes | ||||
| Please describe | Hypothyroidism | ||||
| Please list all conditions and their respective medications |
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| Prescription medications and/or natural remedies? | Yes | ||||
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| Serious illness, injury, or major surgery in the last 5 years? | No | ||||
| Communicable Diseases? | No | ||||
| Current psychotherapy, counseling, or psychiatric treatment? | No | ||||
| Do you have any concerns about your physical or mental health that may impact your participation in this program? | No | ||||
| Will you require any special accommodations/needs during your participation in the Integral Yoga Therapy program? | No | ||||
| Any Dietary Restrictions/Choices (Allergies, Vegan, Gluten Free, etc.)? | Yes | ||||
| Please describe | Vegan | ||||
| Education | |||||
| Highest level of education completed | High School/GED | ||||
| Other work outside of teaching Yoga | |||||
| Occupation |
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| Current occupation(s) and number of years worked - Please list |
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| Occupation |
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| Past occupation(s) and number of years worked - Please list |
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| Previous Yoga Experience | |||||
| Prior coursework/training | Successful completion of a 200-hour Yoga teacher training from a Yoga Alliance approved school plus a minimum of one year teaching Yoga is required for participation in the Integral Yoga Therapy Program track to become a Certified Yoga Therapist. If you are not a registered Yoga teacher, but are a licensed social worker or health care professional who would like to supplement your practice with Yoga therapy techniques, you are welcome to join the program, but will need to first complete a basic 200 hour teacher training to be eligible to receive certification from the International Association of Yoga Therapists (IAYT). | ||||
| Please upload 200 Hour Yoga Teacher Training Program Certificate to this Application | |||||
| When and where did you receive your 200-hour level Basic Teacher Training? | Blue Heron Wellness, Silver Spring MD | ||||
| Primary 200hr Instructor | Claudia Neuman | ||||
| Have you had a personal practice for at least one year? | Yes | ||||
| How long have you practiced yoga? Describe your personal practice of yoga and how regularly you practice, including the style/tradition of your current practice: | Practiced about 5 yrs. | ||||
| Do you meditate? | Yes | ||||
| How long and how often do you meditate? | daily | ||||
| What other training experience have you had since 200hr teacher training? | Restorative, ITT, SMTT, RajaTT | ||||
| What other styles/traditions of Yoga have you practiced/studied? | Yoga Nidra, Restorative, Breathwork, Chair and Gentle yoga | ||||
| Is English your primary language? | Yes | ||||
| Essay Questions | Please answer the following open-ended questions fully and concisely. | ||||
| Please describe your past/current Yoga teaching experience including location, timeframe, population taught, etc. | 2018 Blue Heron Wellness, mixed level classes weekly | ||||
| Which yoga therapy training programs have you taken? | ITT, Raja and signed up for Basics of Ayurveda that starts in June | ||||
| Have you taken any Yoga therapy training programs? | Yes | ||||
| Do you have any special interests or capabilities that may be relevant? | I'm interested in helping those removing from heart issues and managing stress also interested in helping seniors staying mobile as they age. | ||||
| Please describe your studies and understanding of Ayurveda. | I do not have too much understanding of Ayurveda other than the diet and the doshas. | ||||
| Please describe your studies and understanding of yoga philosophy. | Just finished Raja yoga. I believe we all have the ability to heal and to have a peaceful mind and that mind, body and spirit are all connected. We have to practice to connect all three via practices of yoga. | ||||
| What are your expectations as a student? What do you hope to gain, learn, or work on? | I'm hoping to deepen my knowledge on working with the body and mind to facilitate healing. | ||||
| Why do you want to enroll in Integral Yoga Therapy Certification (IYTh)? | I believe that in continuing my education level to IYT that I can then help in the medical arena for those recovering from heart attacks and stokes and other traumatic health issues. | ||||
| Given your current or future commitments, how will you create the time and space to achieve your goals for the IYTh program and fulfill all of the training requirements? | I am self employed so have flexibility in my schedule. | ||||
| List any interesting things you would like to share about yourself | I am a heart attack survivor and used yoga to heal my mind and body. I wouldn't have succeeded without yoga. | ||||
| Are there any current scheduling conflicts or anticipated events that could affect your ability to attend any of the scheduled modules? | No | ||||
| Please list three references we can contact regarding your IYTh application. One of these references must be deeply steeped in the Integral Yoga Tradition. Please provide name, position, phone, and email address. | I will have to get this information | ||||
| How did you find out about the Integral Yoga Therapy Certification Program? | Integral Yoga Center | ||||
| Agreement | By submitting this form, I hereby declare the above information is true and accurate to the best of my knowledge. I understand that misrepresentation of this information constitutes grounds for the rejection of this application, expulsion from the program and revocation of certification. In the event of rejection, expulsion, or revocation of certification, I understand that I am entitled to no refunds, credits, or adjustments.
I agree to assume all risk of damage or injury that may occur as a student of Integral Yoga Therapy Certification. In consideration of being accepted as a yoga therapy student, the undersigned releases and discharges Integral Yoga, its teachers, and students from any and all claims, demands, actions of any nature, whether present or future, anticipated or unanticipated, known or unknown, that result from the undersigned’s participation in yoga classes or practice of yoga outside of class. | ||||
| Signature | |||||
| IYTh Application Fee | IYTh Application Fee, Qty: 1, Price: $108.00 |
IYTh Applications (all)
