| Are you a 200-hour certified yoga teacher? | Yes, I am a 200-hour certified yoga teacher | |||||||||
|---|---|---|---|---|---|---|---|---|---|---|
| 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 | New York IYI | |||||||||
| 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 | Mary Kay Diehl | |||||||||
| Age | 36-45 | |||||||||
| Email hidden; Javascript is required. | ||||||||||
| Address | 11 Dudley Lane Kings Park, NY 11754 United States Map It | |||||||||
| Phone | 516-524-0878 | |||||||||
| Best days to reach you for your interview |
| |||||||||
| Are you a member of the Integral Yoga Teachers Association | No | |||||||||
| Time of day? |
| |||||||||
| Health Information | ||||||||||
| Do you want to achieve your RYT 500-hour designation during this program? | No | |||||||||
| Chronic Health issues? | No | |||||||||
| Please list all conditions and their respective medications |
| |||||||||
| Prescription medications and/or natural remedies? | Yes | |||||||||
| Condition |
| |||||||||
| Serious illness, injury, or major surgery in the last 5 years? | Yes | |||||||||
| Communicable Diseases? | No | |||||||||
| Please describe | Thyroid Cancer, 2016 | |||||||||
| 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.)? | No | |||||||||
| Education | ||||||||||
| Highest level of education completed | College | |||||||||
| Please list schools attended, year graduated, and degrees obtained: |
| |||||||||
| School |
| |||||||||
| Other work outside of teaching Yoga | ||||||||||
| Occupation |
| |||||||||
| Current occupation(s) and number of years worked - Please list |
| |||||||||
| Occupation |
| |||||||||
| Past occupation(s) and number of years worked - Please list |
| |||||||||
| 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). | |||||||||
| When and where did you receive your 200-hour level Basic Teacher Training? | Be Yoga, Yoga Works NYC | |||||||||
| Primary 200hr Instructor | Jean Koerner | |||||||||
| 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: | I have been a practitioner of yoga since the late '90s, introduced early into the Hatha method through ISHTA yoga, then gradually moved more into a vinyasa style practice. I have had the opportunity to practice different lineages including Ashtanga as well as Iyengar. | |||||||||
| Do you meditate? | Yes | |||||||||
| How long and how often do you meditate? | 1x daily | |||||||||
| What other training experience have you had since 200hr teacher training? | Yoga 500 hour Teacher Training Yoga Works | |||||||||
| What other styles/traditions of Yoga have you practiced/studied? | ISHTA, Vinyasa, Ashtanga, Iyengar | |||||||||
| 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. | Currently I am one of the senior teachers at Simplicity Yoga Studio in Kings Park, NY. I have been teaching there since its opening in 2010. As well as teaching Open Level and Beginner classes I lead the Anatomy portion of 200/500 Simplicity Teacher Training as well as co-teach Asana Labs and Energy Workshops | |||||||||
| Have you taken any Yoga therapy training programs? | No | |||||||||
| Do you have any special interests or capabilities that may be relevant? | I hold a NYS license as a Physical Therapist Assistant since 2016. Marrying both my experience in yoga teaching with my knowledge of the physical body, I have a keen interest in helping those who have musculoskeletal issues, post op/rehabilitative and those who may have neurological disorders discover the benefits of a yoga practice. | |||||||||
| Please describe your studies and understanding of Ayurveda. | Early on with my ISHTA training there were lecture series given by Dr. Pratima Raichur on the foundation and use of the practice and benefits of Arurveda. My knowledge base on this topic is not as well versed as other aspects of yoga and healing arts. | |||||||||
| Please describe your studies and understanding of yoga philosophy. | Since beginning my yoga journey I have found that I often reference Patanjali's Yoga Sutras as a foundation for my teaching and own personal understanding of yoga philosophy. I also have shifted recently returning to the work of Jack Kornfeld and Ram Dass as well. | |||||||||
| What are your expectations as a student? What do you hope to gain, learn, or work on? | As a student I do expect that I will be challenged with knowledge from the professionals in the field as well as grow in new, undiscovered understanding of the yoga tradition, in active asana, arurveda and philosophy. | |||||||||
| Why do you want to enroll in Integral Yoga Therapy Certification (IYTh)? | I wish to further my knowledge base of yoga as a therapeutics tool as well as its healing capabilities, both with physical and mental/emotional conditions. | |||||||||
| How do you intend to use yoga therapy in your practice, both personally and professionally? | I wish to expand beyond my current teaching level to work in a case by case basis, one on one with practitioners who wish to use yoga as more of a therapeutic tool. personally I am excited to learn more the the multi-layered facets of the practice. | |||||||||
| 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 will work accordingly with my current profession to take educational days as well as designed sacred space in my home for future studies. | |||||||||
| List any interesting things you would like to share about yourself | When I first began yoga over 20 years ago I never knew the wonderful career path that it would carve out. I have met the best of teachers, made the greatest of friends and challenged myself with various students who have made me the teacher I am today. I am looking forward to sharing all this potential knowledge to once again travel down a different path, full of wonder. | |||||||||
| Are there any current scheduling conflicts or anticipated events that could affect your ability to attend any of the scheduled modules? | As long as advanced notice of modules is available I will be able to schedule accordingly. | |||||||||
| 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. | Rosanne Sihler Amy Ippolito Sabrina Fregara | |||||||||
| How did you find out about the Integral Yoga Therapy Certification Program? | Web Search | |||||||||
| What print and/or online Yoga and wellness publications you read frequently and what social media you follow for Yoga information? | Yoga Journal | |||||||||
| 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 |


