Application for Svastha Yoga Therapy Program

April 14 - 18, 2012
Fri, Mon, Tues:  9am -5 pm
Sat, Sun: 10am - 6pm
Cost $650.00

A deposit of $250.00 is required. Full payment is due by Oct 1st.


Name

First

Last
Address

Street Address

Address Line 2

City

State / Province / Region

Postal / Zip Code

Country
Email
Phone Number

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Please give a brief history of your personal practice
Are you currently teaching?
If yes, for how long?
If teaching, what style?

What style do you usually practice?
Do you have a personal yoga and meditation practice? If so, please explain in brief.
Please list your Teacher Trainings.
All information provided will be treated confidentially. Please submit payment in person or by mail to AYC:
Ashtanga Yoga Center
4000 Abemarle St. NW.
Washington. DC 20016
A deposit of $250.00 is required. Full payment is due by April 1st.

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