| 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 | 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 | Becca Moss | |||||||||||||||
| Age | 46-55 | |||||||||||||||
| Email hidden; Javascript is required. | ||||||||||||||||
| Address | 39 Lindas Mdws Chapel Hill, NC 27516-9726 United States Map It | |||||||||||||||
| Phone | 9193603188 | |||||||||||||||
| 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? | 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? | Yes | |||||||||||||||
| Do you have any concerns about your physical or mental health that may impact your participation in this program? | No | |||||||||||||||
| Please describe | I see a therapist 1-2x month for | |||||||||||||||
| 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 | Graduate | |||||||||||||||
| 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? | EmbodiYoga - Lisa Clark - Chapel Hill, NC | |||||||||||||||
| Primary 200hr Instructor | Lisa Clark | |||||||||||||||
| 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 practiced yoga since 1997 and the first 9 years or so I practiced asana and meditation daily. 2006 to 2016 I was raising a family and practiced most days although there certainly were days when I did not practice and the time on the mat or cushion was less during this time although just as rich of a practice. Since 2013 I have returned to a daily practice with more emphasis on meditation 10-20minutes a day or multiple times a day while still practicing asana 20-45minutes a day | |||||||||||||||
| Do you meditate? | Yes | |||||||||||||||
| How long and how often do you meditate? | Generally daily 10-20 minutes | |||||||||||||||
| What other training experience have you had since 200hr teacher training? | I was grandfathered in through Yoga Alliance as a Registered Prenatal Yoga Teacher as I had been mentored in prenatal/postnal yoga by a local yoga teacher and taught for years before the requirement to take an official training. I have studied with my teacher Ti Harmony in Carrboro, NC for 24 years, Lisa Clark, | |||||||||||||||
| What other styles/traditions of Yoga have you practiced/studied? | Hatha with Erich Shiffmann | |||||||||||||||
| Is English your primary language? | Yes | |||||||||||||||
| Essay Questions | Please answer the following open-ended questions fully and concisely. | |||||||||||||||
| Have you taken any Yoga therapy training programs? | No | |||||||||||||||
| How did you find out about the Integral Yoga Therapy Certification Program? | Web Search | |||||||||||||||
| 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 |


