First Name *
Last Name *
Email Address *
Telephone Number *
Address *
Where and with whom have you studied and for how long? *
Have you studied with Michael before? * Yes No
What is your practice? *
Do you have a daily meditation practice? If yes, please explain your practice. *
Do you have a daily asana practice? If yes, please describe your practice. *
Why are you interested in taking this course? *
Do you teach yoga? *
What are some of the challenges you might encounter in the course? *
Are you on any medication? *
Are there any disabilities we should know about? *
Do you have any chronic or present injuries we should know about? *
Any final comments? *
If you wish to send an image of yourself in an email, send one to michaelstone@centreofgravity.org