FYT ADVANCED ASSESSMENT & THERAPEUTIC PLANNING APPLICATION

Full Name*

Name as you would like it to appear on Certificate*

Pronouns You Identify With

Email Address*

Phone Number*

Mailing Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Course you are applying to take?*

I understand that preparatory learning is required for all MariaAlive trainings, including CEU's. This preparatory learning will be provided by MariaAlive Therapeutics. This preparatory learning MUST be completed before any "live" portions of the training (if this applies).*

I understand

I understand that all courses are offered virtually until further notice.*

I understand

Please describe your education and/or professional credentials.*

How many years have you been practicing yoga and/or other movement practices?*

How many years have you been teaching yoga? If you are not a yoga teacher, put "0"*

Please check your professional affiliations (scroll down to see all choices)*

Certified Yoga Teacher
Certified Yoga Therapist (C-IAYT)
Certified Pilates Therapist
Functional Movement Specialist
Fitness Trainer
Licensed Allied Health Professional (L.ac., PT, OT, LMT, etc.)
Licensed Medical Professional (RN, DO, DC, MD, PA, LPN, etc.)
Other

Are you currently enrolled in Inner Peace Yoga Therapy program?*

Yes
No

If Yes, which cohort?

Are you a past graduate of Advanced FYT who is repeating the course a second time?*

Yes
No

If Yes, which cohort?

Do you have any health conditions or individual challenges that we should be aware of?

Briefly share your goals for taking this course.*

How did you hear about this training?*

Maria Alive

therapeutics

FYT ADVANCED ASSESSMENT & THERAPEUTIC PLANNING APPLICATION

Application for Advanced Trainings