Ananda Seva Yoga Teacher Training
Registration Form

Please complete the form below and send it, with your deposit, to:
Yoga Teacher Certification Program, Ananda Seva Mission, P. O. Box 2862, Santa Rosa, CA 95405
Please make checks payable to Ananda Seva Mission.
To pay by VISA, MasterCard, Discover or American Express please call our office.

If you have any questions, please call us at (707) 575-0886 or email us at: asm@anandaseva.org

Personal Contact Information:

First Name:	Last Name:
Address:	Email Address:
Home Phone:                                  Cell Phone:	Work or Alternative Phone:

Emergency Contact Information:

	Name:	Address:	Phone Number(s):
Nearest Relative:
Primary Physician:

Medical Information:

Allergies:
Physical Limitations (injuries, illnesses, any health issue that affects your yoga practice):
Special Dietary Needs or Food Allergies:
Other Special Needs:

Please check your accommodation package:

If paying by check, please include a deposit for $500. Balance is due on arrival.

Deposits are refundable up until one month prior to the start of the first session, less a $100 administrative fee deduction. No credit or refund is available if you do not give proper notice, if you do not show up, or if you leave early. You may pay your deposit or balance by check or credit card (Visa, MasterCard, American Express and Discover Card are accepted). Call our office for paying by credit card.

We are located at 4378 Bennett Valley Road, Santa Rosa, CA 95404. You can fly either to Oakland Airport (OAK) or San Francisco International Airport (SFO) and take the Airport Express (http://www.airportexpressinc.com) to Santa Rosa. They leave from both airports hourly. You are welcome to arrive early to swim, hike, hot tub, or meditate. The training will either be onsite or at a nearby location. For camping at the center: Towels are not provided, please bring your own. In general, all students should bring an alarm clock, flashlight, slippers (as we do not wear shoes indoors). Bring your own yoga mat, props, belt and blanket. If you like, bring a seat or pillow for meditation and seminars. Please, no smoking, drugs, alcohol, pets, scented body products, incense, candles or other flammables.