Application for Admission Yoga Therapy Extension Certificate 4825 Mount Royal Gate SW, Calgary AB T3E 6K6 T: 403.440.6867 W: conted.mtroyal.ca/yoga How to Apply 1. Submit the following documentation with completed application: a) Statement of Career Investigation Complete the enclosed form, detailing: • Your work experience as a yoga teacher (hours, type of class, contact). • Your personal practice. • Why you feel you are well suited to a career as a yoga therapist. • What you have done in order to adequately prepare yourself for admission to the program. b) 200-Hour Yoga Teacher Training Certificate (or equivalent) Completion of 200-hour yoga teacher training is required (provide documentation). 2. Include a non-refundable $100 application fee. Provide a credit card number or make cheque payable to Mount Royal University. Do not send cash through the mail. 3. Submit the application package in one of the following ways: In Person: Mount Royal University, Lincoln Park Campus Continuing Education and Extension Registration Services 4825 Mount Royal Gate SW; Kerby Hall (East Gate) Room A101, Wickets 9 & 10 Call 403.440.3833 or toll free 1.877.287.8001 for current hours Mail: Mount Royal University Continuing Education and Extension Registration Services 4825 Mount Royal Gate SW, Calgary, AB, T3E 6K6 Fax: Continuing Education and Extension Registration Services 403. 440.6743 When to Apply Early Admission Fall Semester December 1 – April 30 Enrolment is limited. It to your advantage to apply during the early admission period since the program can only accommodate a limited number of students. Applicants who apply for early admission will be considered within 4-6 weeks of their date of application. Applications may be accepted after the early admission period, pending space availability. Visit the website for updates. For More Information Website: Telephone: Toll-free: E-mail: conted.mtroyal.ca/yoga 403.440-6867 1.866.616.3606 cehealth@mtroyal.ca Statement of Career Investigation Yoga Therapy Extension Certificate 4825 Mount Royal Gate SW, Calgary AB T3E 6K6 T: 403.440.6867 W: conted.mtroyal.ca/yoga Please discuss the following topics in the space available. Please list your work experience as a yoga teacher (hours, type of class, contact). Please describe your personal practice. Why do you feel you are well suited to a career as a yoga therapist? What have you done in order to adequately prepare yourself for admission to this program? I, ________________________________________________, declare that I have completed a 200-hour yoga teacher training program (documentation required), one year of yoga teaching experience (suggested 30-40 hours) and one year of personal practice. I have foundational skills in the following: • Teaching methodology and principles of learning as they apply to yoga • Techniques of yoga – including but not limited to – asanas, pranayamas, kriyas, chanting, mantra and meditation • History, philosophy and spirituality from the yoga scriptures • Ethics and lifestyle for yoga teachers I acknowledge that I have the prerequisite knowledge, skills, experience and personal practice to be fully prepared for admission into the Yoga Therapy Certificate at Mount Royal University. By signing this document I am indicating to Mount Royal University that I meet the requirements to be accepted and take full responsibility for my learning. ____________________________________________________ Signature ______________________________________ Date 3/17/14 Application Form Yoga Therapy Extension Certificate 4825 Mount Royal Gate SW, Calgary AB T3E 6K6 T: 403.440.6867 W: conted.mtroyal.ca/yoga PLEASE PRINT CLEARLY AND ANSWER ALL QUESTIONS COMPLETELY Have you previously applied to or have you ever attended Mount Royal University? Yes No If Yes, your Student ID number: Personal Information Last Name (family name) First Name (legal) Middle Name (legal) Previous Name (if applicable) Gender Male Birth date dd mm yy Female Mailing Address (Street/PO Box #) City/Town Province/Country Postal Code Telephone - Home Telephone - Business Fax (if available) ( ( ( ) Citizenship Status Canadian Citizen Landed Immigrant Student Visa Work Permit Other ) Expiry date of your Visa (if already issued) dd mm yy ) Country of Citizenship _________________________________________ First Language (mother tongue) _________________________________________ English Language Proficiency requirement may apply E-mail Emergency Contact Name Telephone ( Alberta Student Number (if available) - - ) Previous Education Most recent High School Attended / Credential Earned City/Province From mm Post-Secondary Institution Attended / Credential Earned City/Province To yy mm yy mm From mm yy To yy Other 3/17/14 Method of Payment ($100 application fee) Cash/Debit (in person only) Cheque (Mount Royal University) VISA MasterCard Card Number Expiry Date Cardholder's Name Cardholder's Signature Money Order Applicant Survey How did you hear about the program? Print (please specify):_____________________________________________________________________________________ Referral (please specify):__________________________________________________________________________________ Online (please specify):___________________________________________________________________________________ Other (please specify): ______________________________ ____ Why did you choose our program? ___________________________________________________________________________________________________________ ____________________________________________________________________________________________________________ ____________________________________________________________________________________________________________ ____________________________________________________________________________________________________________ Declaration Have you included: Documentation/Yoga Teacher Training Certificate Statement of Career Investigation Application Fee I certify that I have read all of the instructions and information accompanying this application form and that the information I have provided on the application form is true. Signature of Applicant _________________________________________________ Date ____________________________________________________ Freedom of Information and Protection of Privacy The information that you provide to Mount Royal University when you register for Continuing Education courses is collected under the authority of the Post-Secondary Learning Act and Freedom of Information and Protection of Privacy Act in the Province of Alberta, Section 33(c). This information will be used for academic administration, the administration of Mount Royal support services, scholarship and financial aid awards, marketing and recruitment activities. Your personal information is protected and can be reviewed upon request. The complete statement and further contact information is available at conted.mtroyal.ca/cefoip. 3/17/14
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