Loka Yoga School
Yogify Your Life!
200-hour Yoga Teacher Training
Student Application Form 
*Mandatory field

* Full Name:
* How frequently do you practice yoga (daily, weekly, monthly)?
* Email address:
* Country Code:
* Country:
* Date of Birth (Day/ Month/ Year):
*Course Date and Location:
* Full Home Address
* Passport Number:
* Phone Number:
* Are you male or female?
* Do you have any food allergies?
* Do you have any physical limitations/injuries that may prevent you from an extensive asana practice or for sitting for extended periods of time? If yes, please describe:
* Current Occupation:
* Preferred Name:
* Are you currently taking any form of medication?
* How did you hear about our yoga course?
* How long have you been practicing yoga? Please explain experience and styles of yoga explored.
* What do you hope to get out of this immersion/teacher training? Please list the 3 primary things.
* Have you got any fears or apprehensions about the upcoming training?
* Facebook / Instagram account name?
* Have you ever received professional medical treatment due to any psychological condition?
* Is there anything else it would be helpful for us to know about you or your past? (e.g. social therapy, anxiety issues, etc)
* At Loka Yoga we serve vegetarian food, and we encourage you to explore that diet with us. Y/N? If no, please advise us why?
* Do you have any specific food requests? Please know that we will do our best to cater for you, but depending on the request, it may not be possible.
* EMERGENCY CONTACT - Relationship to you
* EMERGENCY CONTACT - Email address
* EMERGENCY CONTACT - Contact phone number (please include country code)