yoga teacher training 200 hour PROGRAM - APPLICATION FORM

1. Program Dates:   July 2 - 15 and August 5 - 15, 2010
 
2. Personal Information:

Full Name   __________________________________________________ Phone______________________________________

E-Mail  ______________________________________________________ Fax ________________________________________

Complete Mailing Address__________________________________________________________________________________

_______________________________________________________________________________________________________

Age  __________ Gender  __________ Occupation______________________________________________________________

 

3. emergency contact information:  

Contact Name   ________________________________________ Relationship ______________________________________

Phone  ______________________________________________ E-Mail ___________________________________________

 

4. Please list any Food Allergies:   _________________________________________________________________

 

5. would you like to be housed with friends or family? Please list their names: ________________________

 

Rates for accommodation and tuition are calculated separately.

 
6. Accommodation Session 1
(13 nights)
Session 2
(10 nights)
Total Meals & Lodging
Commuter $ 585 $ 450 $1,035
Camping (Own tent/van) $ 728 $ 560 $1,288
Dormitory $ 975 $ 750 $1,725
Triple occupancy $1,079 $ 830 $1,909
Double occupancy $1,209 $ 930 $2,139
Single occupancy $1,482 $1,140 $2,622
 

During Session 1:
My first choice for accommodation is  ________________________________________   at  $ ____________
My second choice for accommodation is  _______________________________________   at  $ ____________

During Session 2:
My first choice for accommodation is  ________________________________________   at  $ ____________
My second choice for accommodation is  _______________________________________   at  $ ____________


7. Tuition AND APPLICATION FEES:
  $2400

8. Payment Plan: Yes, I am interested in the Payment Plan. please forward information_______.

A fee of $50 should accompany this application.  This fee will be refunded if you are not accepted into the course. Once we have received your application you will be emailed within two weeks to confirm your acceptance into the program.  Included in that email will be your student contract which needs to signed and returned with a payment of $450 to reserve your space in the program. The remainder of all fees are due by June 1 unless you have chosen the payment plan. Rates are quoted in Canadian dollars and include all applicable taxes.

We now accept credit cards, but have not yet implemented on-line payments.   If you wish to pay by credit card, please contact us by telephone at (250) 537-2326. Your credit card number will not be kept in our files subsequent to processing your payment. Please do not under any circumstances send your credit card information by e-mail. We also take Canadian or US cheques and/or money orders. Payments in US funds will be credited toward program fees at the prevailing exchange rate.

9. How did you hear about this program?
Our web site ______ Internet ______ Brochure ______ Referral __________________________ Other ______________


I hereby declare the above information is correct and complete.


Sign: _________________________ Date: _________________________

 

The Salt Spring Centre of Yoga
355 Blackburn Rd., Salt Spring Island, BC, Canada V8K 2B8
Phone: 250-537-2326   Fax: 250-537-2311  Email: yoga@saltspringcentre.com