Your Name (required) Street Address City, State, Zip Code Your Email (required) Primary Phone Number Occupation 1. Are You A Kriyaban? YesNo If Yes, with whom and when did you receive it? 2. Have You Taken the SRF Lessons? YesNo If Yes, give the last lesson completed 3. Have you attended at least 2 class series of Golden Lotus Yoga? YesNo If yes, please give teacher’s name and approximate date 4. What previous styles of hatha yoga classes have you taken and for how long? 5. What is your daily home yoga practice, if any? 6. Have you had previous Hatha Yoga Teacher Training? YesNo If yes, when and with what organization? 7. Have you had meditation training? YesNo If yes, in what traditions? 8. What is your is your spiritual background? 9. How did you find out about GLSY and our Teacher Training Program? 10. Do you have any special conditions, concerns or physical needs? 11. Please write a short letter stating your reasons for wanting to be trained as a Golden Lotus Yoga Teacher.