SHANTAYA YOGA & BODYWORK SCHOOL
INSPIRED TEACHINGS & EFFECTIVE THERAPEUTIC TOOLS TO ENJOY & SAVOR THE FULLNESS OF MODERN LIVING


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APPLICATION TO
YOGA FUSION RETREAT
Kaomailannana resort, Chiang Mai
NOVEMBER 10-17, 2012

Complete all the fields below and submit.


TITLE:
FIRST NAME:
FAMILY NAME:
NAME I LIKE TO BE CALLED:
HOME ADDRESS:
STATE/PROVINCE:
PHONE:
COUNTRY:
EMAIL:
RETYPE EMAIL:
OCCUPATION:
BIRTH DATES:
A PHOTO OF YOURSELF: (1 MB maximum)
 
   
ACCOMMODATIONS:
SPECIFY SHARED OR SINGLE ROOM?
HOW LONG HAVE YOU BEEN PRACTICING YOGA AND WHAT STYLE(S)?
DETAIL YOUR BACKGROUND IN ANUSARA YOGA (IF ANY)?

YOU DO NOT NEED ANY PRIOR EXPERIENCE WITH ANUSARA!
IF YOU TEACH YOGA, GIVE DETAILS?
MEDICAL CONDITIONS, PHYSICAL LIMITATIONS, INJURIES?
ANYTHING ELSE YOU WOULD LIKE TO SAY OR ASK?
 
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