| 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 | Beth Bissmeyer | ||||||
| Email hidden; Javascript is required. | |||||||
| Address | 3226 Linwood Avenue Cincinnati, OH 45226 United States Map It | ||||||
| Phone | 5135202981 | ||||||
| Best days to reach you for your interview |
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| Are you a member of the Integral Yoga Teachers Association | No | ||||||
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| Health Information | |||||||
| Do you want to achieve your RYT 500-hour designation during this program? | Yes | ||||||
| Chronic Health issues? | No | ||||||
| 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? | Yes | ||||||
| Do you have any concerns about your physical or mental health that may impact your participation in this program? | No | ||||||
| Please describe | Family and marriage counseling. | ||||||
| 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? | 2010 Moksha( Modo) International | ||||||
| Primary 200hr Instructor | Ted Grand | ||||||
| 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 practicing yoga since 2007 after my 4th child was born. I attended a 4 week intensive yoga training in Toronto, Canada in 2010. I teach and practice in a hot yoga room as I enjoy the sweaty detox that accompanies the heat. The yoga I teach is a series of alignment based postures that are held for a longer periods than in a traditional Vinyasa class. In addition to yoga, I also attended an online Mediation certification program through Tracee Stanley in 2020. As far as my personal practice, I attend classes at least 3 x a week and currently teach 1 class a week as that is what my schedule allows given my other job. | ||||||
| Do you meditate? | Yes | ||||||
| How long and how often do you meditate? | 20-30 minutes 5 days a week | ||||||
| What other training experience have you had since 200hr teacher training? | I also attended an online Mediation certification program through Tracee Stanley in 2020. | ||||||
| What other styles/traditions of Yoga have you practiced/studied? | Yin, Vinyasa, Baptiste | ||||||
| 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 have conci | ||||||
| Have you taken any Yoga therapy training programs? | No | ||||||
| Do you have any special interests or capabilities that may be relevant? | I really have an interest in Yoga Therapy for mental health. I have seen so many loved ones struggle in this area and would love to be able to add the teachings of yoga therapy to their toolbox when dealing with mental health struggles. | ||||||
| Please list any other training or experience that you think is relevant. | I participated in an online Meditation certification program through Tracee Stanley in 2020. As far as experience I assist at our studios teacher trainings. In the summer and fall I teach a free weekly outdoor class in a park because I want all people to have access to the healing benefits of yoga. | ||||||
| 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. | ||||||
| IYTh Application Fee | IYTh Application Fee, Qty: 1, Price: $108.00 |


