| 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 | Marilyn Louise Russell N/A | |||||||||
| Age | 56-65 | |||||||||
| Email hidden; Javascript is required. | ||||||||||
| Address | PO Box 159 Mill Valley, CA 94942 United States Map It | |||||||||
| Phone | 4157226021 | |||||||||
| Best days to reach you for your interview |
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| Are you a member of the Integral Yoga Teachers Association | Yes | |||||||||
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| Health Information | ||||||||||
| Do you want to achieve your RYT 500-hour designation during this program? | Yes | |||||||||
| Chronic Health issues? | No | |||||||||
| Prescription medications and/or natural remedies? | No | |||||||||
| 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.)? | No | |||||||||
| Education | ||||||||||
| Highest level of education completed | College | |||||||||
| Please list schools attended, year graduated, and degrees obtained: |
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| 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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| 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). | |||||||||
| When and where did you receive your 200-hour level Basic Teacher Training? | Integral Yoga Institute - SF | |||||||||
| Primary 200hr Instructor | Diana Meltsner | |||||||||
| 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’ve practiced yoga for over 20 years. My first exposure to yoga was at my gym. My friend, Susan Ford, later introduced me to IYI-SF in 2013. I’ve practiced Hatha, Restorative, Ashtanga, Vinyasa, Bikram, Iyengar, Yin, Sivananda, etc. | |||||||||
| Do you meditate? | Yes | |||||||||
| How long and how often do you meditate? | 5-6x per week for minimum of 20 minutes | |||||||||
| What other training experience have you had since 200hr teacher training? | Meditation TT, Intermediate TT, Intro to Therapeutic Yoga, Foundations, Yoga & Psychology (Mala), Raja, and Stress Management | |||||||||
| What other styles/traditions of Yoga have you practiced/studied? | I’ve practiced Hatha, Restorative, Ashtanga, Vinyasa, Bikram, Iyengar, Yin, Sivananda, etc. | |||||||||
| 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. | I began teaching at IYI-SF upon completion of my Basic TT. I taught a regular class in Hatha 1/2. I continued to teach Hatha 1/2 and 2 after receiving my Intermediate TT. I also assisted teaching Restorative classes upon completion of the Intro to Therapeutic Yoga training led by Cheri Clampett and Arturo Peal. I’ve also taught ‘basic Yoga’ including Chair and pranayama to friends, family and a small start-up company. | |||||||||
| Which yoga therapy training programs have you taken? | I’ve completed the Foundations and SMTT courses. I’m in the middle of the Yoga & Psychology and Raja TTs. | |||||||||
| Have you taken any Yoga therapy training programs? | Yes | |||||||||
| Do you have any special interests or capabilities that may be relevant? | I’m a life-long spiritual seeker and certified life coach. I’ve also studied NLP. | |||||||||
| Please list any other training or experience that you think is relevant. | I’m a certified Life Coach from the Co-Active Training Institute (CTI). | |||||||||
| Please describe your studies and understanding of Ayurveda. | I am familiar with Ayurveda basics and look forward to enrolling in a TT as soon as possible. | |||||||||
| Please describe your studies and understanding of yoga philosophy. | I am currently in the middle of the Raja TT. I’m amazed at the timeless, pragmatic and universal wisdom of yoga philosophy. I appreciate its true ecumenical nature. As Satchidananda taught, “Truth is One. Paths are many.” This basic tenet succinctly describes yoga philosophy. | |||||||||
| What are your expectations as a student? What do you hope to gain, learn, or work on? | As a student, I’m ready to take a deep-dive into all that Yoga Therapy and the IYTh training offers. I envision my role as a yoga therapist as one who empowers clients with tools and resources that they can use in their daily lives while offering ongoing support on their journeys. | |||||||||
| Why do you want to enroll in Integral Yoga Therapy Certification (IYTh)? | Having completed several of the IYTh core modules, I’m committed to completing this certification. The prerequisites and elective trainings are spot-on for the contribution that I envision building - a hybrid yoga therapy-life coaching practice for target audiences including corporate workers, seniors and trauma survivors. | |||||||||
| How do you intend to use yoga therapy in your practice, both personally and professionally? | Yoga therapy will enable me to provide clients and groups with specific tools and insight that they, as well as myself, can apply to our daily lives. | |||||||||
| 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 not working right now. I am currently seeking work that will offer me the flexibility in hours / schedule needed to meet all of the training requirements. | |||||||||
| List any interesting things you would like to share about yourself | I love music, movies, comedy, hiking, downhill skiing, tennis, traveling, and I’m a fledgling birder too! | |||||||||
| Are there any current scheduling conflicts or anticipated events that could affect your ability to attend any of the scheduled modules? | Right now, I do not foresee any scheduling conflicts. The only conflict that might arise would be a health crisis in my family. | |||||||||
| 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. | My 3 references: Susan Ford - suford@earthlink.net / 415-407-4297 - I believe she’s already submitted a letter of recommendation | |||||||||
| How did you find out about the Integral Yoga Therapy Certification Program? | Integral Yoga Center | |||||||||
| Please provide specific website, studio, or individual names if you can, as well as any other specific information on how you heard about the program | Integralyogasf.org | |||||||||
| What print and/or online Yoga and wellness publications you read frequently and what social media you follow for Yoga information? | Yoga International / Himalayan Institute / MD University of Integrative Health / Sivananda Center / Accessible Yoga / Yoga Alliance / IYTA | |||||||||
| 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 |


