Yoga Polarity Center (YPC) Home of Long Island Institute For Yoga Therapy (LIIYT) Yoga Therapist Training Program Application. Date of Application:

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Annabelle Green
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1 Yoga Polarity Center (YPC) Home of Long Island Institute For Yoga Therapy (LIIYT) Yoga Therapist Training Program Application Date of Application: What Years are you applying for: Name: Home Address: (city, state, zip) Home Phone: Mobil Phone: Work Address: (city, state, zip) Work Phone: Address: Current Occupation: Please circle your yoga designation and any other credentials; ie. 200RYT, 500RYT, e- RYT200, e-ryt500, RCYT, RPYT, Other How many hours do you have teaching yoga

2 Outline and describe your primary vocational history. Outline your academic history. Outline your yoga studies and training, specifying areas of particular interest. Briefly describe your current yoga practice and style. Describe your studies and understanding of the yoga sutras, and any other of the classical texts of yoga.

3 Have you been through any personal therapeutic process, such as yoga or physical therapy? Briefly describe the nature of the work and length of treatment. How did this process affect your understanding of yourself and the healing process? In what other forms of personal growth work have you engaged? What is your understanding of a yoga therapist and how does a yoga therapist differ from a yoga teacher? Describe a student/situation that you would like to learn how to handle differently or more fully through your therapist training. Reviewing your description, list at least three questions that you could ask of this program and/or a mentor.

4 What are some of the ways that you facilitate your students carrying what they learn from classes in a formal setting off the mat and into their lives? Below, please list the names, addresses and telephone numbers of your two references who can knowledgeably and honestly assess your potential to become a yoga therapist. Please ask these people to fill out the enclosed reference form for you and send it to us at: Yoga Polarity Center (YPC)/Long Island Institute For Yoga Therapy (LIIYT), 32 Church Street, Malverne, NY, 11565, Att: Heather Principe as soon as possible. One of these references needs to be a yoga teacher or therapist who has mentored you, the other a colleague or yoga peer. 1. Name: Please circle one: Yoga teacher Yoga Therapist Colleague Yoga Peer Phone Address: 2. Name: Please circle one: Yoga teacher Yoga Therapist Colleague Yoga Peer Phone Address:

5 Please write a short essay [3-4 pages] that includes answers to the following questions OR answer them as separate questions and attach to this application: 1. What attracts you to this program? 2. What important life experiences have led you to this point that you feel you want to be a yoga therapist? 3. What do you hope to receive from this program? 4. With whom and how do you expect to use your training? 5. Please describe an incident in which you offered something like yoga therapy (in a formal or informal way) to another person. 6. What do you feel are the most important qualities for a yoga therapist to embody? 7. How would you assess your strengths as they relate to becoming a yoga therapist? 8. How would you assess your blind spots, or samskaras that may impact your effectiveness as a yoga therapist in working with others?

6 YPC LOGO Yoga Polarity Center (YPC) Home of Long Island Institute For Yoga Therapy (LIIYT) Yoga Therapist Training Program Date: Dear, (Reference s Name) has applied for entrance into Long Island Institute of (your name) Yoga Therapy (LIIYT) Yoga Therapist Training Program, beginning, (date) and has given your name as a professional reference. Please use this form to provide us with your thoughts and experiences that will further assist in the application process. These are some questions to address in your reference: 1. How did you come to know the candidate? 2. How long do you know the candidate? 3. What is your relationship with the candidate? Ie, are you a mentor, colleague, or peer? 4. What has been your experience in this role with the candidate? 5. Anything you feel is important to enhance the candidate s application. Please return this form as soon as possible, to Yoga Polarity Center (YPC)/Long Island Institute For Yoga Therapy (LIIYT), 32 Church Street, Malvern, NY, Att: Heather Principe. Please feel free to use additional pages and attach to this form.

RIBTS Scores * Program. Program RIBTS1 RIBTS2 RIBTS3 RIBTS4 RIBTS5 RIBTS6 RIBTS7 RIBTS8 RIBTS9 RIBTS10 RIBTS11

RIBTS Scores * Program. Program RIBTS1 RIBTS2 RIBTS3 RIBTS4 RIBTS5 RIBTS6 RIBTS7 RIBTS8 RIBTS9 RIBTS10 RIBTS11 FEINSTEIN SCHOOL OF EDUCATION AND HUMAN DEVELOPMENT EXIT PORTFOLIO, SPRING 2009 RIBTS ANALYSIS: PROGRAM RIBTS Scores * Program Program RIBTS1 RIBTS2 RIBTS3 RIBTS4 RIBTS5 RIBTS6 RIBTS7 RIBTS8 RIBTS9 RIBTS10