Application Form for the Life Centre Yoga Teacher Training Programme Level 1 (200 Hour s1

Application for Mother and Baby Yoga Teacher Training With

with Uma Dinsmore-Tuli

Venue: Moving Arts Base, 134 Liverpool Road, Islington,

London N1 1LA

Fri, Sat, Sun 18th, 19h, 20th May 2012 and Fri, Sat, Sun

28th, 29th and 30th September 2012 (total 6 days)

10am - 5pm each day.

NAME ______

ADDRESS ______

______

EMAIL ______

CONTACT TEL NUMBERS ______

AGE ______Are you fluent in English? Yes q No q

The course is designed for existing yoga teachers who already have a yoga teaching qualification and teacher trainees. We will however consider, on a case by case basis, applications from teachers, parents and people qualified in a complementary health discipline who have a strong personal yoga practice, who want to teach yoga to families. If this applies to you please state your qualifications and describe your yoga practice below, continuing on a separate sheet if you need to.

A) About you

Are you a qualified yoga teacher or teacher trainee? (please circle one) YES / NO

For teachers:

What yoga teaching qualification do you have? When did you gain this qualification? How long have you been teaching yoga?

For trainee teachers:

Which organization are you training with? When will you finish your yoga teacher training?

For all other applicants:

What relevant qualifications or work experience do you have that draws you towards teaching family yoga? Please describe in detail your yoga practice (length of time, style, how frequently you practice, main teachers, classes/workshops attended in the last year).

B) Your interest in this course

1. What specifically is of interest to you in teaching family yoga?

2. Do you have any previous experience of teaching family yoga? Please describe it.

C) Is there anything else that is relevant to your application? Please let us know if you have any current health consideration. If you are pregnant you are welcome on the course however please do let us know your due date.

Course fees, transfers and cancellation

The course fee is £525. Please make cheques payable to Yogacampus or write your credit card details (sorry, not American Express or Diners Club) below (we will destroy this part of the form once the card payment has been processed).

Please note that you are booking a course and must commit to attending all of the course to receive your certificate. If, due to an emergency, you have to miss a day or half day session, you will need to catch up the session(s) on a later course. If you miss a full day of the course you will need to restart the course the next time it is run. If you miss a half day of training you need to catch up the missed session on the next intake of the course. The charge for moving to the next course is £125 and the charge to catch up a missed half day session is £60.

You may cancel this booking up to 30 days before the course start date although we will charge you an administration fee of £25. If you wish to cancel within 30 days of the start date then there will be no refund, unless there is a waiting list for this course and we can transfer your booking to another applicant.

Courses will run only if there are sufficient numbers.

Please sign and date the booking form below and return it with your payment to:

YOGACAMPUS (Head Office address), Suite 10 - Redan House, 27 Redan Place

London W2 4SA - Tel : +44 (0)207 042 99 00/ 01 - Email:

SIGNATURE ………………………………………………………….
DATE………………………………..

Credit card number ………………………………………………………………………..

Expiry Date………….. Start Date…………..
Issue number (if applicable) ………..

3 Digit Security Number (on reverse)………………………………………………….

Name of holder if different to above…………………………………………………..