2014-2015 Registration Form


  KRI Level 1 Kundalini Yoga Teacher Training Certification Program October 2014 - June 2015
3717 N. Ravenswood Ave., #220W, Chicago, IL 60613 | 773.975.9754 | www.spiritrisingfoundation.org


Participant Registration Form 
             Please note: All information will be kept confidential.                             Birth Date: ___________________

Legal Name /Spiritual Name:  _________________________________________________________________________________________
Address: _________________________________________________________________________________________________________
E-mail Address:_________________________________________________________________________________________________________
Primary Phone Number: ___________________________Secondary Number: ________________________________________________________
Emergency Contact/Phone/Relationship: ______________________________________________________________________________________

How did you hear about this training?
___Internet Search ___Spirit Rising Yoga website ___3HO, KRI or IKYTA Website
___Friend or Yoga Teacher’s referral (Who can we thank?) _______________________________________________________________________

Have you had previous experience with Kundalini yoga classes? ___Yes ___No
If yes, please tell us more about where you’ve practiced and the name(s) of the Kundalini Yoga teacher(s): ___________________________________________________________________________________________________________________
___________________________________________________________________________________________________________________

Tell us about your primary interest in this teacher training; i.e., teaching Kundalini Yoga, deepening your personal yoga practice, etc.
____________________________________________________________________________________________________________________
____________________________________________________________________________________________________________________
____________________________________________________________________________________________________________________
What are the key factors that impacted your decision to choose Spirit Rising Foundation’s Teacher Training course?
____________________________________________________________________________________________________________________
____________________________________________________________________________________________________________________
____________________________________________________________________________________________________________________

Do you have any medical issues or physical limitations that affect your ability to participate in this program or teach Kundalini Yoga? ___Yes ___No If yes, please explain more. __________________________________________________________________________________________________________
_____________________________________________________________________________________________________________________

Tuition: If you are interested in enrolling, do you prefer:

___ Pre-registration ($3200 by 8/1)      ___ Full Registration ($3300* by starting date 10/11/14)
___ Payment Plan ($3500* in installments)
___ FT Student/Senior/over 62 – 10% discount ($2970* paid in full by 10/11/14 or $3150* as Payment Plan in installments)

Are you considering applying for the Kenny Velez/Guru Kar Singh Memorial Scholarship?   Yes   No

*Completed registration form and deposit of $600 (applicable to tuition) are due by September 1, 2014 ($175 non-refundable).
- Tuition does NOT include registration for the White Tantric Yoga course or the cost of the required 20 yoga classes outside of KYTT
- Refunds are determined on a case by case basis. See your contract for full details.
- A 3% processing charge is added to all credit card transactions.



Office Use Only: Entrance Interview Completed Date ____________   Deposit Received Date __________________