Toggle navigation
Menu
Yoga
Get Started
Purchase a Class Pass
MindBody Frequently Asked Questions
Pay Practice Forward Scholarship
Health Policies & Procedures
Instructors
Styles
Schedule
Weekly Class Schedule
Purchase a Class Pass
Events
MindBody Frequently Asked Questions
Health Policies & Procedures
Recorded Class Online Library
Massage CE Courses
Yoga Teacher Training
Overview & Requirements
Tuition & Schedule 2021
Faculty
Application
Physical Therapy
Massage & Continued Education
Glowing Body Thai Yoga Massage
Why Thai?
Schedule a Massage
Meet Our Therapists
Massage CE Courses
Thai Yoga Certification
Studio Policies
Gift Cards
Name
*
First
Last
Address
*
Street Address
Address Line 2
City
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
State
ZIP Code
Mobile Phone
*
Home Phone
Email
*
Date of birth
*
Month
1
2
3
4
5
6
7
8
9
10
11
12
Day
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
Year
2022
2021
2020
2019
2018
2017
2016
2015
2014
2013
2012
2011
2010
2009
2008
2007
2006
2005
2004
2003
2002
2001
2000
1999
1998
1997
1996
1995
1994
1993
1992
1991
1990
1989
1988
1987
1986
1985
1984
1983
1982
1981
1980
1979
1978
1977
1976
1975
1974
1973
1972
1971
1970
1969
1968
1967
1966
1965
1964
1963
1962
1961
1960
1959
1958
1957
1956
1955
1954
1953
1952
1951
1950
1949
1948
1947
1946
1945
1944
1943
1942
1941
1940
1939
1938
1937
1936
1935
1934
1933
1932
1931
1930
1929
1928
1927
1926
1925
1924
1923
1922
1921
1920
Marital status
Yes
No
Children?
Yes
No
Emergency contact:
Emergency contact name
*
First
Last
Emergency contact phone
*
Relationship to contact
*
Yoga experience
How long have you been practicing? - months/year(s)
Styles studied
Studio(s)/school(s)
Teacher(s)
Please list any yoga workshops or trainings you have attended.
Where do you currently practice yoga? What style? Who is your teacher?
Getting to Know You
What does yoga mean to you? (200 words max)
*
Why do you want to participate in Glowing Body Yoga Teacher Training? (200 words max)
*
Please describe your recent yoga practice, including any breakthroughs or challenges. (200 words max)
*
What are your expectations for GBTT? What do you hope to learn? (200 words max)
*
Please tell us about yourself. Family, work, pets, education, hobbies... Anything you wish us to know. (200 words max)
*
The following will be used by our training staff to better assist you during GBTT. Your information will be kept strictly confidential. Please tick the appropriate box and explain any positive answers.
Are you taking any prescription medication?
Yes
No
If "yes" please list/describe medications.
Physical limitations or disabilities?
Yes
No
If "yes" please list/describe limitations or disabilities.
Communicable disease(s)?
Yes
No
If "yes" please list/describe disease(s).
Serious illness?
Yes
No
If "yes" please list/describe illnesses.
Surgeries?
Yes
No
If "yes" please list/describe sugeries
Pregnant or trying?
Yes
No
Have you or do you use or consume:
Tobacco
Yes
No
Alcohol
Yes
No
Recreational drugs
Yes
No
Illicit substances
Yes
No
If you answered yes to any of the above, please describe your usage.
Agreement
*
I agree
By clicking "I agree" I hereby attest that all information provided is correct. I also agree to adhere to the terms set forth by Glowing Body Yoga Studio.
