I am applying for: * Winter - February 22nd, 2025 Summer Intensive - June 14th 2025 Name * First Name Last Name Home Address * Address 1 Address 2 City State/Province Zip/Postal Code Country Email * Phone * (###) ### #### Date of Birth * MM DD YYYY Emergency Contact Name * Someone other than you. First Name Last Name Relation * Emergency Contact Address * Address 1 Address 2 City State/Province Zip/Postal Code Country Emergency Contact Phone * (###) ### #### Education Background * Schools Attended & Dates * Occupation & Employer * Hobbies/Activities * Injuries/Physical Concerns * Do you have any allergies? Please list below: * How did you learn about us? * What is your background in yoga? Tell us about your yoga practice and training. * What first brought you to yoga and how long ago? Do you have any significant experiences you would like to share about your personal or professional practice? * What teachers have had the most influence on you and why? * Have you ever taken any yoga teacher training before? Please provide any pertinent details... * What are your goals for taking this course? What do you hope to take away from this experience? * Please add anything else about yourself that you feel is pertinent, such as injuries, limitations, weaknesses, strengths, special skills, areas of interest, etc... * We have received your application for the upcoming trimester. To secure a spot please contact Mark Weiss the Executive Director of The Chicago School of Yoga via phone or email at: 1-312-617-3630 or mark.csoy@gmail.com Pay with Venmo @sendpmt or with Cash or Check
