Wufoo

Name: * First Last
Name you prefer to be called
Please upload a photo. *

Given that we work with numerous students each year, please attach a photo with your application. We are unable to accept and consider applications without a photo attached.
Address: *
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
E-mail: *
Phone Number: * ### - ### - ####
Emergency Contact Information
Emergency Contact Name: * First Last
Relationship to you: *
Phone Number: * ### - ### - ####
IYT Training Information
Please list which 300- and 800-hour modules you have taken: *
300-Hour Advanced Teacher of Therapeutic Yoga graduation date: MM / DD / YYYY
800-Hour Professional Yoga Therapist graduation date: MM / DD / YYYY
Are you currently teaching therapeutic yoga? *
Yes No
Have you had previous assisting experience at Kripalu? *
Yes No
Please describe why you are interested in serving as a School of Integrative Yoga Therapy assistant: *
What qualities and skills would you bring to the assistant role? *
Are you able to assist for the whole length of the module (includes arriving the day before the program starts through clean up on the last day)? *
Yes No
If No, please explain:
Please describe your experience with keeping commitments. *
Please describe your experience and ability to work as a team. *
Please describe your experience with creating and holding safe space. *
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