Application form –Assessment

Application for the following level – tick relevant box:

Level 1: ☐ Level 2: ☐ Level 3: ☐ Level 4: ☐

Fill in and answer the questions below as fully as possible. Send the signed application by email to: teknisk-udvalg@iyengaryogaorg.dk

Click to add photo:

Name:	Klik eller tryk her for at skrive tekst.

Address:	Klik eller tryk her for at skrive tekst.

Postcode and city:	Klik eller tryk her for at skrive tekst.

Country:	Klik eller tryk her for at skrive tekst.

Phone:	Klik eller tryk her for at skrive tekst.

Email:	Klik eller tryk her for at skrive tekst.

Date of birth:	Klik eller tryk her for at skrive tekst.

Occupation:	Klik eller tryk her for at skrive tekst.

1 – Is this assessment a retake? (Tick box)	Yes ☐	No ☐

If yes, indicate where and when your last assessment took place:

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2 - Information about your yoga practise, mentorship/Teacher training and teaching of yoga:

Started practise of yoga:	Klik eller tryk her for at skrive tekst.

Started practise of Iyengar Yoga:	Klik eller tryk her for at skrive tekst.

Started mentorship/teacher training Iyengar yoga:	Klik eller tryk her for at skrive tekst.

Started teacher training – any other yoga:	Klik eller tryk her for at skrive tekst.

Started teaching yoga:	Klik eller tryk her for at skrive tekst.

How often do you practice and for how long?

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3 – Pranayama practise:

Do you practise Pranayama? (tick box)	Yes ☐ No ☐

If yes, how often and of which types?

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4 – If you teach, how many classes do you teach a week?

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5 – List any experience or qualification you have in any of the following subjects: Physical education, movement and dance, anatomy, physiology, human biology, medicine, nursing, or any other subject you consider relevant.

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6 – List the names of your main yoga teachers (that you have studied with on a regular basis) and the periods of study (which months /years:

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Declaration by candidate

Name of my recommending mentor / Teacher trainer: Klik eller tryk her for at skrive tekst.

I understand that my application is not valid until the Technical Committee has also received a filled in declaration by my mentor / Teacher Trainer (form available at www.iyengaryogaorg.dk) AND the assessment fee has been paid.

I understand that in training to teach as an Iyengar Yoga Teacher at a given level, I must uphold the standards of the association of which I am a member and keep to the rules of the association as well as guidelines given from RIMYI in Pune.

I accept that the information in this form will be shared with the assessors and moderator that will be assigned to conduct the assessment.

I understand that I type my name in the field below as signature of the form:

Signature:	Klik eller tryk her for at skrive tekst.

Date:	Klik eller tryk her for at skrive tekst.

Send this filled in form (preferably in PDF format) to Technical Committee at the email teknisk-udvalg@iyengaryogaorg.dk and make sure to pay the assessment fee (Technical Committee will inform you of how to pay.