Please complete in clear print or type. Keep it to a maximum of
2 letter size sheets. Send with $20 application fee. This fee will
be refunded if you are not offered a place in the program.

YOGA MENDOCINO, Foundations in Yoga
206-A Mason Street
Ukiah, CA 95482

For questions call 707/462-2580
or email yomo@pacific.net
www.yogamendocino.org

Name:

Address:

Email (essential):

Phone: Day:

Phone:Night:

Please answer the following questions as succinctly as possible.

1. How did you hear about the program?

2. Why are your interested in this program?

3. Are you interested in our 600 hour Yoga Mendocino Certificate?

4. Give a condensed version of your Yoga History. Include any teacher training and senior teachers you have worked with.

5. Where do you see your future going in terms of yoga teaching/
practice?

6. Have you attended a longer (5-10 day) silent meditation retreat?
Are you willing/able to attend one before/during the course?

7. Describe your current practice. Do you practice pranayama?
Do you meditate?

8. What else do you do with your life?

9. Can you commit to the practice and study commitment as outlined in the flyer? Do you have a local teacher with a minimum of 10 years of teaching experience?

10. What anatomy/physiology study have your covered in the past?
Prerequisite information and test will be sent on receipt of application.

11. Philosophy Background: Have your studied the sutras? Are you familiar with Richard Freeman’s Yoga Matrix? Prerequisite information and test will be sent on receipt of application.

12. If you are a teacher, describe your teaching experience.

13. Are you taking medication or pharmaceutical drugs of any source of any kind currently? If yes, please give details and short history.

14. Have you had a psychotic breakdown in the past, and if so how did you heal from this situation?

15. Do you drink? If so, how much?

16. Do you smoke? How much? Have you smoked in the past?

17. Is there anything else you need to tell us about that might effect your yoga and your participation in this program?

18. Any questions/concerns you have about the program? Anything that you need more information about?

Thank you for applying. We look forward to seeing you!