| 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 | 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 | Eiji Takamori | ||||||
| Age | 56-65 | ||||||
| Email hidden; Javascript is required. | |||||||
| Address | 2 Tudor City Place 11LN New York 10017 United States Map It | ||||||
| Phone | 718-809-8384 | ||||||
| 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). | ||||||
| Please upload 200 Hour Yoga Teacher Training Program Certificate to this Application | RYT200.pdf | ||||||
| When and where did you receive your 200-hour level Basic Teacher Training? | 2017 - Integral Yoga Institute NYC | ||||||
| Primary 200hr Instructor | Kali Morse | ||||||
| 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 10 years. I meditate every day and practice Hatha and Yin Yoga 5 days a week. | ||||||
| Do you meditate? | Yes | ||||||
| How long and how often do you meditate? | 20 mins / day | ||||||
| What other training experience have you had since 200hr teacher training? | Therapeutic Yoga Level 1, Therapeutic Yoga Level 2 | ||||||
| What is your primary language? | Japanese | ||||||
| Is English your primary language? | No | ||||||
| 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. | Restorative Yoga IYI NY 2019~ | ||||||
| Have you taken any Yoga therapy training programs? | No | ||||||
| Do you have any special interests or capabilities that may be relevant? | I practice Japanese Tea Ceremony which is one of my mediation as well. I can talk the concept of the some Japanese traditional culture into mindfulness practice. | ||||||
| Please describe your studies and understanding of Ayurveda. | Basic | ||||||
| Please describe your studies and understanding of yoga philosophy. | I am studying Raja Yoga (Yoga Sutra of Patanjali) now. | ||||||
| What are your expectations as a student? What do you hope to gain, learn, or work on? | In addition to the training I have completed so far, I would like to deep my knowledge on theory of Yoga Therapy and learn more about relationship medical condition and yoga. | ||||||
| Why do you want to enroll in Integral Yoga Therapy Certification (IYTh)? | I completed my Basic TT at IYI NY, and I took some other training afterword. | ||||||
| How do you intend to use yoga therapy in your practice, both personally and professionally? | As I mentioned above, I would like to use therapy technique in my senior group class, and I want to be able to expand my teaching to more private clients in US and Japan. | ||||||
| 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 have completed 4 of core modules, therefore I can focus remaining modules rest of this year and 2022. | ||||||
| List any interesting things you would like to share about yourself | I live in NYC now, but planning to spend half of my time at other location in a year or two. Unlike New York, there are none or not many Yoga Therapist, I am planning to practice as Yoga Therapist also as volunteer as well. | ||||||
| Are there any current scheduling conflicts or anticipated events that could affect your ability to attend any of the scheduled modules? | I have no schedule conflict at this time, the only concern is location of on-site training in 2022 and after. | ||||||
| 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 provide later with separate email | ||||||
| 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 | Integral Yoga Institute NY | ||||||
| What print and/or online Yoga and wellness publications you read frequently and what social media you follow for Yoga information? | - Yoga Journal, Harvard Medical School news letter and publication, | ||||||
| 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)
