Name

Email

Prerequisite: Are you a new Yoga Therapy Student registering for the 2-year certification program?

I have completed a 200 hour Yoga Teacher training: 

I have been Teaching Yoga for at least one year: 

I have been practicing yoga for at least one year:

Profession(s):

I am applying for:

(NYC Service Scholarship Question, if You are applying for another write ’N/A’) 

I am a yoga professional living in the New York City Area: 

(NYC Service Scholarship Question, if You are applying for another write ’N/A’) 

I have been economically affected by the pandemic: 

Are you willing to teach one Zoom class for NYC public school teachers a week when school is in session?

Required:  In a few sentences, please tell us why you wish to complete PYI's Yoga Therapy Certification Program. We would love to hear your personal and/or professional reasons.

 Optional:  To further help us provide information more readily to all communities, and to continue to grow our diversity leadership scholarships, please tell us:  Which pronouns do you prefer we use when addressing you:   Which culture(s) or race(s) do you identify with: 

By electronically signing this form, I attest that all the information submitted is true.  I understand that if chosen, my scholarship duties will be to teach an online Zoom yoga class for NYC public school teachers and professionals for 30 weeks of the year for the 2 years of my scholarship. I agree to follow the Scope of Practice of a yoga teacher as established by the Yoga Alliance, and to be a professional representative of PYI.  PYI will then match my hours worked with additional scholarship funds, resulting in approximately a 50% discount off my tuition and application fees.

*Electronic Signatures. This agreement is signed when a party’s signature is delivered by facsimile, email, or other electronic medium. These signatures must be treated in all respects as having the same force and effect as original signatures.

Please write Full Name below to electronically sign this agreement: