Registration form for Yoga Teacher

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Yoga Teacher Registration Form

If already Registered Click here to Modify Your Information

The Fields marked with * are mandatory Fields.

Personal Details

* Country

* Name

* Address

* City

* State

If your state is not listed, then select other to enter your state.

*Postal/Zip Code

*Show Contact Details

YesNo

Phone Number

Display Phone Number
YesNo

Yoga Technical Details
Web address	:
Upload Your Photo	:
*Yoga Style's	:	Ashtanga YogaGeneral Yoga Hatha YogaIntegral Yoga Iyengar YogaKripalu Yoga KriyaKundalini Yoga Power YogaPregnancy Yoga Sivananda YogaVinyasa Yoga Other

Other Styles	:	If you have selected "Other" above then please specify:
Available For	:	Private Instruction Class Instruction
Level(s) taught	:	Beginner Intermediate Advanced
Total number of classes taught (per week)	:
Total Yoga Experience (In Years)	:
Your Certification (if any)	:
Additional Comments	:	(Any added information to help know you better)

Pricing

You may specify cost details here

Your Main Yoga teaching purpose:

	Teaching Beginners Yoga (General)
	Physical Fitness (Movements and Flow)
	Yoga Therapy or Disease Management
	Spiritual Growth
	Relaxation

Teaching Components include:

	Physical Postures (Asanas)
	Meditation / Awareness Techniques (Pratyahara, Dharana, Dhyana)
	Breathing (Pranayama)
	Cleansing techniques (Shatkarmas, Shatkriyas)
	Does this include Jala Neti? Yes No
	Relaxation Techniques (Yoga Nidra etc.)

Login Details

* eMail	:	Your Email will not be displayed.
User ID(Optional)	:
* Choose Password	:
* Confirm Password	:
Please provide a minimum 4 character password. This will allow you to update your listing in the future, as well as access additional healthandyoga.com Studio resources.