Minnesota Insitute of Ayurveda Application for Admission to Ayurveda Program Form mnayurveda.com 1/2017
ApplicationforAdmission–AyurvedaProgramApplicationFees-$100duewiththisapplication.$200duewhenacceptedtoprogram.
PersonalInformation
Name(Last)___________________________________(First)____________________________(MI)______
Address___________________________________________________________________________________
City_____________________________________________________State_____________Zip___________
Telephone(cell)______________________________Alternatephonenumber__________________________
DateofBirth_______________________Emailaddress___________________________________________
U.SCitizen/PermanentResident____Yes____No Ifno,pleasecompletethenextsection:
CountryofCitizenship__________________________VisaType_______________IssueDate___________
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CurrentOccupation________________________________________Employer________________________
EmergencyContact:Name____________________________________Telephone#____________________
**************************************************************************************************EducationHistoryDoyouhaveaHighSchooldiplomaorequivalencydocument?_____Yes_____No
Pleasereportanypost-secondary(College/University)educationaswellasanyothercertificateorprofessionaltrainingyouhaveobtained.NameandAddressofSchoolattended Datesyouwereenrolled Degreeyoureceived
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BrieflydescribeyourcurrentAyurvedaandYogapractices.
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Doyouteachyogaorhaveyouevertaughtyogainthepast?Ifso,whatstyleofyoga?Ifyouhavearegularyogapractice,whatstyleofyogadoyouprefer?__________________________________________________________________________________________________
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This Ayurveda program is physically and mentally/intellectually challenging in terms of hours of class time as well as home study.Itisinyourbestinteresttoundertakeself-inquirytodetermineyourabilitytocompletethisrigorousprogram.
Pleasedescribeyouroverallphysicalhealth.Haveyouhadanysurgeriesorchronicillnessordoyouhaveanyphysicallimitation?Pleasedescribehere.
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Pleasefeelfreetotellusanythingelseaboutyourselfyouwouldlikeustoknow.
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We would like to hear about what you hope to learn and achieve from studying Ayurveda.
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Wewouldalsoliketohearaboutyourplansfollowingcompletionoftheprogram,ifany.
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Minnesota Institute of Ayurveda Application for Admission to Ayurveda Program Form mnayurveda.com 1/2017
Minnesota Institute of Ayurveda Application for Admission to Ayurveda Program Form mnayurveda.com 1/2017
IdeclarethattheinformationIhavesubmittedforthisapplicationistruetothebestofmyknowledge.
Signature______________________________________________________Date______________________
Print this application and mail it along with the $100 application fee to: Minnesota Institute of Ayurveda 2637 27th Ave. So. Suite 224 Minneapolis, MN 55406
