IYTA (NZ) Enrolment Page 1 of 5

INTERNATIONAL YOGA TEACHERS ASSOCIATION (N.Z.) Inc.

IYTA (NZ)

ENROLMENT FORM

Yoga Teaching Diploma

Please print clearly in capitals:

Name…………………………………………………………………………………………………

Date of Birth:

Street number & Name: ..…………………………………………………………………………………………………….…

Suburb: ……………………………………………………………………………………………...

City: ………………….……………...……………………………………………………………….

Postal code: ………………………………………………………………………………………...

Phone Number/s: ………………..………………………………………..……………………….

Email:…………………………………………………………………………………………………

Please advise if you have access to a computer Yes No

Please list any required text books that you may already own:

………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………

I wish to enrol in the Yoga Aotearoa IYTA (NZ) 2017-2018

  • Teaching Diploma Course

I enclose a cheque for $1050

or

I would like to pay by direct credit

IYTA (NZ) Training Account: BNZ 02 0112 0305140 000

Please put your full name under Reference and Course Deposit under Payer details.

The balance of $3150 to be paid in three instalments:

$1050each on or before 01 June 2017, 01 September 2017 and 01 March 2018

NB Subject to change due to workshop venues increased fees, yet determined.

Questionnaire

  1. How long have you been involved in yoga? ......
  1. What other areas of yoga besides asana have you explored to this point?

For example: yoga philosophy, use of breath, meditation etc.

………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………

  1. Meditation:
  1. Are you currently meditating? Yes No
  2. If so, what meditation technique are you using? ………………………………………………………………………………………… .……………………………………………………………………………………….. …….…………………………………………………………………………………..

4. Yoga Study/Training Courses:

  1. Have you previously undertaken a yoga study or training course?

Yes No

  1. If so, where and with whom? …………………………………………………………………………………………
  1. Name(s) of yoga teacher(s) (if any)………………………………………………………………………………………………… …………………………………………………………………………………………………
  1. What is your understanding of the term “Yoga”? ………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………

…………………………………………………………………………………………………

  1. Have you spoken about the course with your yoga teacher/regional coordinator? ……………………………………………………………………………………………………………………………………………………………………………………………………
  1. Have you talked over your intention to apply for inclusion on this course with your partner/family?

………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………

  1. Do you, as far as you know, have any health limitations, or planned pregnancy, which would prevent you from participating fully in the academic, experiential and meditative activities of the IYTA (NZ) Course?

…………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………

  1. Are you willing to commit to 14 hours minimuma week for course-related work?

…………………………………………………………………………………………………

  1. Teaching Diploma Requirements:

a.If you are accepted, are you willing, to the best of you ability, to accept the requirements of the course? (Initial the boxes)

Code of Ethics
Personal study
Personal practice
The other requirements as set out in the ‘Requirements’ on pages 3 & 4 of the Course Outline

b.If you have any reservations about participating in any of the above please give details/explain: …………………………………………………………………………………………….… ………………………………………………………………………………………….…… ……………………………………………………………………………………….……… ……………………………………………………………………………………………....

  1. Please share significant life experiences which you think have been of particular value in preparing you for this course of study: ……………………………………………………………………………...……………………………………………………………………………..……………………………………………………………………………..……………………………………………………………………………...……………………………………………………………………………

(Continue on back of sheet if necessary)

  1. Where did you find out about this course? …………………………………………………..…………………………………………….…………………………………………………………………………………………………
  1. Why do you wish to become a yoga teacher?

…………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………International Yoga Teachers’ Association (N.Z.) Inc.

Teaching Diploma Course 2017-2018

ACCEPTANCE/DECLARATION: I have read and understood the IYTA (NZ) Code of Ethics and the requirements of the Teaching Diploma Course as listed above. I accept them.

Name: ………………………………………………………………………………………….

Signature:……………………………………………………………………………......

Date:

………………………………………………………………………………………….

Please post or emailthis completed form, together with cheque or details of date when direct credit was paid for the first instalment of fees ($1050) to IYTA (NZ)Training Accountto:

Amanda Percival

Flat 9/48 Chester St West

Christchurch 8013

Mob:021 0830 1662

Please note:

Applications must be made in writing and accompanied with the first instalment of fees.If you have a query please phone or email

Amanda Percival

021 0830 1662

Enrolments are taken in order of arrival, but with preference given to existing members of the Association and those who have already done the IYTA (NZ) ‘Introduction to Yoga Mini Course’.

Enrolment FormAuthorised by: Course Co-ordinatorIYTA (NZ)

Date Reviewed: July 2016Next Review: August 2018Copyright