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					APPLICATION FOR YOGA WORKS CERTIFICATION

2009
Name Address Line 1 Address Line 2 City Home Phone Email Address I completed the Yoga Works 200hr Teacher Training in the following month and year: With the following instructor(s): To be eligible for certification, students must complete 500 hours of approved Yoga Works course work, as well as pass a written and practical exam segment which involves teaching before a panel of senior teachers. The 500 hours can be accumulated in two ways: 1) 2) 200-Hour Teacher Training Program + 300-Hour Professional Program 200-Hour Teacher Training Program + 300 Hours of Electives State Work/Cell Phone Today’s Date:

Zip Code

Please submit your completed application, the attached certification worksheet and your payment to the Teacher Training Department. If your application is received by the early registration date, you will be charged the discounted rate of $75. The regular price for the Orange County Certification is $100. Please view our website for details on price deadlines, dates, times and location. Orange County Los Angeles:

YogaWorks Teacher Training
129 Cabrillo Costa Mesa, CA, 92627 Fax: 310-564-7759 Phone: 949-631-7447 fayc@yogaworks.com

YogaWorks Teacher Training
2215 Main St. Santa Monica, CA, 90405 Fax: 310-564-7759 Phone: 310-664-6470 x120 rasha@yogaworks.com

2009 Orange County Certification October 17 & 18, Newport Studio Saturday & Sunday 12:30-4:30pm You will need to reserve the entire 4 hours on your scheduled day. We will contact you TWO WEEKS prior to the Certification Weekend with the day & timeslot of your 30 minute practice teaching segment. You will be given your sequence ONE WEEK before your exam. You will complete your written exam in the time before and/or after your practice teaching. Do not miss the free preparatory Info Session on September 18, from 1-3 pm at the Costa Mesa Studio

APPLICATION FOR YOGA WORKS CERTIFICATION

2009
PAYMENT INFORMATION
Full payment is required to reserve your space in the program. If your application is received by the early registration deadline, you will be charged the discounted rate. Please visit our website I am paying by check. Please mail the check with your application to the appropriate address on the Application Instruction page. *Please include driver’s license number, State and expiration date on the front of you check. I am paying by credit card. Credit Card # Name as it appears on the card: Is your billing information the same as your mailing address? Yes No. My billing address is: City State Zip Code MasterCard Visa American Express Expiration Date

I hereby authorize the above payment of $

Please initial:

PROGRAM PARTICIPATION AGREEMENT
I understand that if I cancel 7 days prior to the start of the Certification Weekend, I can receive a full refund. If I cancel within 7 days of the start of the training, the payment is non-refundable unless the space can be filled. Once the certification weekend begins, payment is non refundable and nontransferable. I have read and accept the above terms and requirements:

Yes

No

Signature

Date (M / D / YY)

APPLICATION FOR YOGA WORKS CERTIFICATION

2009
About Yoga Works Certification The path to becoming a professional yoga teacher is a unique and deeply satisfying journey. This process will give you the opportunity to express your creativity, unlock your potential and develop your own voice as a yoga teacher. The Teacher Training programs at Yoga Works have been designed to deepen your knowledge of yoga, provide you with in-class experience, and prepare you for the Yoga Works certification exam. We encourage you to pursue your passion and make a professional statement by joining us for the bi-annual certification assessment. Requirements To be eligible for certification, students must complete 500 hours of approved Yoga Works course work, as well as pass a written and practical exam segment which involves teaching before a panel of senior teachers. The 500 hours can be accumulated in two ways: 1) 200-Hour Teacher Training Program + 300-Hour Professional Program 2) 200-Hour Teacher Training Program + 300 Hours of Electives. If you complete the 200-hour Teacher Training and the 300-Hour Professional Program, you will have met all the requirements and will be eligible to apply for the Yoga Works Certification examination. If you are pursuing the second path, electives include the 100-hour Vinyasa Flow Training, 100-hour Roots of Yoga, Teachers Intensives and workshops with approved teachers. You must complete 35 hours of anatomy, 50 hours of philosophy, and 6 hours of pre-natal yoga which can be accumulated though a combination of intensives and workshops. You can document your progress on the attached worksheet. Full participation is required in order to receive full credit for each course.

APPLICATION FOR YOGA WORKS CERTIFICATION

2009
Certification Worksheet
These requirements must follow after the completion of the Yoga Works Teacher Training course. A total of 500 hours must be completed in order to qualify for the Yoga Works certification examination. After your initial 200 hour training you are required to complete 35 hours of anatomy, 50 hours of philosophy & 6 hours of pre-natal yoga. Yoga Works Teacher Training Program (200 hours) Course Date:_______ Teachers:____________________ Professional Program (300 hours) Course Date:_______ Mentor:______________________ Mentor signature:________________________ Teacher signature:____________________

Specialty Topics and Classes
(This is required if you do not participate in the 300-hour Professional Program) Beginners: Take a 2-day Intro to Yoga Course: Course date:________ Teacher signature:_______________________ Take a how to teach beginners workshop: Workshop date:_________ Teacher signature:_______________________ Prenatal: Take 5 Prenatal Classes and 1 Prenatal Workshop: Class dates/studio: 1)____________2)___________3)____________4)____________5)_____________ Prenatal Workshop Information: Date:_________ Hours: ____

Title:_________________________ Teacher:______________________

APPLICATION FOR YOGA WORKS CERTIFICATION

2009
Intensives, Workshops and other electives
This is required if you do not participate in the 300-hour Professional Program. The below must include 25 hours of anatomy coursework, 30 hours of philosophy course work & 15 hours of pranayama classes and/or workshops. Date:_________ Hours: ____ Date:_________ Hours: ____

Title:_________________________ Teacher:______________________ Date:_________ Hours: ____

Title:__________________________ Teacher:_______________________ Date:_________ Hours: ____

Title:_________________________ Teacher:______________________ Date:_________ Hours: ____

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APPLICATION FOR YOGA WORKS CERTIFICATION

2009
Teacher:______________________ Teacher:_______________________

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Title:_________________________ Teacher:______________________ Date:_________ Hours: ____

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Title:_________________________ Teacher:______________________ Date:_________ Hours: ____

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Title:_________________________ Teacher:______________________

Title:__________________________ Teacher:_______________________

Once you have completed your 500-hours worth of approved course work, please submit this form along with your Certification Application. For more information on YogaWorks Certification, please visit our website at www.yogaworks.com

APPLICATION FOR YOGA WORKS CERTIFICATION

2009


				
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