Yoga for Life
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Yoga for Life
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| Teacher / Advanced Training 2007 Cost: $600 due with Registration Form
Name ________________________________ Date of Birth: _________________ Address ___________________________________________________________ Home Phone: ____________________ Bus. Phone: ________________________ Email: ______________________________ Fax: __________________________ Employer: ________________________ Profession: _______________________ List any Health or Physical Problems:____________________________________ _________________________________________________________________ What would you like to learn from this course:_______________________________ _________________________________________________________________ _________________________________________________________________ Number of years practicing Yoga: _______________________________________ How many yoga classes do you attend weekly:_____________________________ What styles of Yoga do you practice: _____________________________________ Where do you practice: _______________________________________________ Emergency Contact Name and Phone: ___________________________________
Please return this application with your check for $600 payable to Robert Connell Signature: ____________________________________ Date: ____________________ Send to: Robert Connell 12 Terry Drive, Suite 201, Newtown, PA 18940 Email: yogaguy@yoga-for-life.org Phone: 215-497-7050
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Copyright © 2006 Yoga for Life
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