reduced yoga logo for web pages new tiny size

200hr Mindfulness Meditation Teacher Training

Application and Booking form 

Title –

First name –

Surname -

Email address –

Address –

Your telephone or skype contact details –

Next of Kin contact details –

Date of birth –

 

Are you happy for your email to be shared with other course participants for travel sharing from the airport to the shared pick up point?

 

Date of course you wish to apply for –

 

How did you hear about us?

 

Please tell us a little about yourself, including your current occupation –

 

 

Please include brief details addressing the following questions –

  • A very brief outline of how you plan to use mindfulness in your professional context. How does/will your personal practice integrate with and support this?

 

 

  • What mindfulness teaching experience (if any) do you have?

 

 

Tell us about your personal meditation practice –

 

  • How long have you been practicing meditation?

 

  • What is your practice?

 

  • What challenges and delights; sustains and supports you in your practice?

 

  • How do you use your practice in difficult times?

 

Anything else you would like us to know –


 

Overall Health Questionnaire.

 

Please answer the following questions so that we can work together safely. If you answer yes to any of the questions and/or have any areas of concern, please give as much details as possible. All information given is treated with the strictest of confidentiality.

 

  • How would you describe your health overall?

 

 

 

  • Do you have any physical illness or other limitation that may make sitting, standing, walking or doing simple exercise difficult for you?

 

 

  • Do you have any special dietary requirements?

 

 

  • Have you had any mental ill-health within the last few years, such as anxiety or depression? If yes please tell us about it here -

 

 

  • If you are taking any medication at present, please say what it is and what it is for-

 

 

  • Have you had any disturbing life event in the last year, which may make the course difficult for you?

 

  • Any other information -