500 Hour Program Application

500 Hour Program Application Form

Personal Info

First Name *

Last Name

Email Address *

Mailing Address *

City *

State/Province/Region *

Zipcode/Postcode *

Country *

Cell Phone Number *

Other Phone Number

Please check one *
I have completed or am currently enrolled in the YogaSource 200 hour Program
I have completed or am currently enrolled in another 200 hour Program
I have not completed nor am I enrolled in any 200 hour Program

If you are currently enrolled or have completed another 200 hour program, please list:

How did you find out about our program? *

Other Info

Date of Birth (month/day/year) *

Occupation *

Employer *

Medical Info

Please write a detailed list of injuries, past surgeries, and other conditions that affect your yoga practice. *

Emergency Contact *

Phone *

Relationship *

Training History

You may automatically apply the YogaSource 200 hour Training towards your 500+ hour certificates. YogaSource may also be able to grant credit for other recent trainings with select faculty, if they exceed the hours on a similar topic offered in our 500+ Hour Program. Such approval is granted on a case by case basis. Please list any trainings for which you would like to receive prior credit. Please do not list workshops or conference hours. If a prior training is accepted, you will need to email a scanned copy of your certificate of completion. If you do not have a certificate, please ask the faculty certifying your completion to email us directly at teachertraining/at/yogasource.com. *

Teaching Experience

Please tell us about your teaching experience, if any. Describe the class(es) you've been teaching, how long, where, to who etc… *

Requested Modules

Please have a look at our website for the up-to-date listing of modules on offer. You can recognize the 500+ modules by their circle logo that says TT500+. Please list all the modules you are currently interested in. Use an additional page if necessary. This will help us get a head start in advising your curriculum and ensuring that your selections align with the requirements of the Yoga Alliance.*

Requested Mentorships

Mentor 1 + Classes*

Mentor 2 + Classes*

Mentor 3 + Classes*

Payments and Waivers

A non-refundable enrollment fee of $195 is required to process this application and periodically review and advise your course selection in order to ensure it meets the standards of other governing bodies, such as the YogaAlliance. We will not charge you unless you are accepted into the program. Please refer to training modules for their individual pricing.

Upon acceptance, the credit card on file for your account will be charged for the enrollment fee. If we do not have a credit card on file for you, please call 408.402.9642 during our business hours and provide us with your VIsa or Mastercard.

500+ TRAINING PROGRAM MODULES REFUND POLICY

In the event of cancellation on applicant’s part:

30 days or more prior to the module: payment is held as credit towards a future training.
29 days or less: at our discretion, payment is held as credit towards a future training.
No refunds or credits are made after the training starts! No exceptions.

YogaSource reserves the right to cancel any training up to 2 weeks prior to start, in which case any payment you have made to YogaSource will be refunded in full. You will not be entitled to make any further claims for compensation or damages, for any loss, consequential damage, expenses, loss of time or inconvenience which may result from such cancellation. Payment of deposit is taken as acknowledgment of and agreement to the above items..

Waiver

In signing below, you agree that you are solely responsible for your own health and safety at all times during the YogaSource Teacher Training. Neither the teacher(s) nor the studio shall be held liable for any injury related to this training. You agree to assume all risks associated with the program in any way. Furthermore, you agree to inform the teacher(s) of any movements which you cannot safely perform and you agree that you will not perform any activity or movement which you feel is likely to cause you to injure yourself. You agree to inform the teacher(s) of any limitations or medical conditions that may affect your practice and understand that you can stop and rest at any time. You agree that YogaSource has permission to use any and all photographs, videos, recordings, writing and other intellectual property created during this training. Such materials shall remain the property of YogaSource. You agree not to share electronic or hard copies of any photography, videos, recordings or writing from your trainings at YogaSource without the written permission of YogaSource.

Electronic Signature *

Today's Date (month/day/year) *

If we do not have your photograph in the system, please submit one electronically. (100Mb Limit)

Verification

Prove you're not a robot *