Application for Advanced Trainings This application is for advanced trainings, including CEU’s offered by MariaAlive Therapeutics. Full Name*Name as you would like it to appear on Certificate*Pronouns You Identify WithEmail Address* Phone Number*Mailing Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Head shot*Please upload a current photo of yourself. This helps Maria and her support team put a face to the info provided. * This photo will only be seen by Maria and the support team. It will never be posted or used outside of this training. Accepted file types: jpg, Max. file size: 5 MB. Course you are applying to take?*Functional Yoga Therapy Advanced Assessment Techniques (65-hours)Structural Assessment StrategiesDesigning an Effective Balance Program for Individuals & GroupsI 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 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?*I'm applying for the 2026:* Fully Virtual My first pick is Tucson but willing to go virtual if it’s already full Please choose what training option your applying for.Please choose how you would like to pay your tuition:* Pay with a credit card Zelle Venmo Pay by check $450 deposit with installment payments due before 10/1/25 Based on what you have chosen you will receive an email with information on how to make that payment.