Applications for teacher training programs are individually reviewed. Due to the structure and intensity of our teacher training programs, enrollment is very limited. We accept last minute applications if there is space in the program. Submission of your application indicates that you have read, understand, and agree to all of the requirements for the training. Once you submit your application, please email a color photo to programs@baronbaptiste.com or send it to BPYI, P.O. Box 400279, Cambridge, MA 02140. Please make sure that your face is clearly visible and that you include your name and the program you are applying for in your subject line. You will hear back from BPYI within 2 weeks. If you have not heard from us after 2 weeks, please call us at 617-441-2144.

Upon acceptance to the program, we will charge your credit card the non-refundable, non-transferable tuition amount and send you a second electronic notification to confirm your acceptance. For those paying by check, please send a check for the $399 non-refundable, non-transferable tuition upon submitting your application. Your application will not be processed without the check. Your check will not be deposited until you are accepted. If you are not accepted to the program, your check will be returned to you. Please note: applications will not be reviewed without a colored photo and a tuition payment.

• Tuition is charged upon acceptance. NO EXCEPTIONS. The tuition is non-transferable/non-refundable.
• We reserve the right to cancel a program at any time.
• Please review our cancellation policy

I have read and understand the above terms and requirements.
Yes  (required)

Please click the Baptiste program that you are registering for.

	Journey Into Power Teacher Training Basics, with Baron Baptiste, Utah, September 2009

Name:
Street Address:
City:
State:
Zipcode:
Country:
E-Mail:
Daytime Phone:
Fax:
Evening Phone:
Occupation:
Gender:	Male Female
Age:
Marital Status:
Emergency contact:
Name:
Phone:
How did you hear about our Teacher Training program?
Have you attended any Baptiste programs before? Yes  No
If so, please list the program year(s) and location(s) here:
Do you currently practice yoga at a Baptiste-affiliated studio? Yes  No
If so, please list the studio name(s) and location(s) here:
Are you interested in learning more about our: Products (videos, CDs, yoga props, clothing) Bootcamps, Workshops & Retreats Studio Information

Please answer all questions to the best of your ability using complete sentences, with a minimum of 50 words where appropriate.
1.	Please list any previous yoga experience (length of time, specific teachers, types of yoga, what is your experience level with Baptiste yoga?).
2.	Please List any NON-Yoga personal growth, transformational based courses, workshops, seminars or retreats you have completed, other than Baptiste programs.
3.	List any other interesting things you think we should know about you.
4.	Do you teach?
	How long?
	Where?
	What is the structure of the class?
	Approximately how many students do you teach?
	How long is each class?

Physical Health Please note that this section of the application is mandatory and that you will not be accepted without filling in these required fields accurately and honestly. How would you evaluate your current health? Excellent Good Fair Some Challenge
Are you currently, or during the last two years have you been under the care of a physician or other health care professional?
Yes No
If Yes, for what reason?
Do you have epilepsy?
Yes No
Do you have diabetes?
Yes No
List the health care professional's name, specialty and address:
Name:
Specialty:
Address:
Please list any medications you are currently taking or have taken in the last year that were prescribed by a health care professional:
Are you currently, or during the last two years have you been, under the care or supervision of a mental health professional(psychiatrist, therapist, etc.)?
Yes No
If yes, for what condition?
Please list the mental health professional's name, specialty and address:
Name:
Specialty:
Address:
Please list any medications you are currently taking that were prescribed to you by a mental health professional:
Have you been hospitalized in the past year?
Yes No
If yes, for what condition?:
Do you have any special dietary requirements? If yes, please list:
Do you currently suffer from an eating or exercise disorder, or have you been treated for an eating or exercise disorder in the past? Please explain.
Do you have any challenges in participating in any physical activities?
Yes No
If yes, please list:
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