Forms Mindbody Wellness Application Form for All Teacher Training Courses Please enable JavaScript in your browser to complete this form.Please enable JavaScript in your browser to complete this form. www.mindbodywellness.org.uk office@mindbodywellness.org.uk Your Name *FirstLastYour Unique Ref. No. (URN)If you already have a current BWY membership number, please insert here. If you will be renewing or joining as a new Student Teacher after you have been accepted on to the course, then leave blank for now.Your Mobile Phone *Can you be contacted on this number via Whatsapp for easy contact by your tutor/assessor?YesNoIf your mobile number is not on Whatsapp, are you wiling to link it to Whatsapp (with help provided if you need it)?YesNoHome Phone / Landline (if applicable)Your Email address *Your Home Address and Postal Code *Address Line 1Address Line 2CityState / Province / RegionPostal Code--- Select country ---AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBolivia (Plurinational State of)Bonaire, Saint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos (Keeling) IslandsColombiaComorosCongoCongo (Democratic Republic of the)Cook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Kingdom of)EthiopiaFalkland Islands (Malvinas)Faroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHondurasHong KongHungaryIcelandIndiaIndonesiaIran (Islamic Republic of)IraqIreland (Republic of)Isle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea (Democratic People's Republic of)Korea (Republic of)KosovoKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesia (Federated States of)Moldova (Republic of)MonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth Macedonia (Republic of)Northern Mariana IslandsNorwayOmanPakistanPalauPalestine (State of)PanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint Martin (French part)Saint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint Maarten (Dutch part)SlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyrian Arab RepublicTaiwan, Republic of ChinaTajikistanTanzania (United Republic of)ThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUgandaUkraineUnited Arab EmiratesUnited Kingdom of Great Britain and Northern IrelandUnited States Minor Outlying IslandsUnited States of AmericaUruguayUzbekistanVanuatuVatican City StateVenezuela (Bolivarian Republic of)VietnamVirgin Islands (British)Virgin Islands (U.S.)Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland IslandsCountryDate of Birth *Gender *FemaleMaleRather Not SaySelect the course you are applying for *--- Select Choice ---BWYQ Level 3 Technical Specialist in Teaching Yoga (Certificate)BWYQ Level 3 Technical Specialist in Adapting and Developing Antenatal Yoga (Award)BWYQ Level 3 Technical Specialist in Adapting and Developing Postnatal Yoga for Mums and Babies (Award)BWYQ Level 3 Technical Specialist in Adapting and Developing Mindbody Exercises for Older Adults (Award)Advertised start date of course *Mode of Study for the advertised course you want to do *OnlineIn-personHybridDo you hold any prior yoga, mindbody wellness or fitness instructor qualifcations? *YesNoIf yes, please specifyBriefly describe your experience in yoga or related fields *Why are you interested in this course? *How did you hear about us? *WebsiteSocial MediaPoster or leafletMagazine/newsletter AdvertisementReferralOtherIf other, please state:Do you have any reasonable adjustments or special considerations for which we will need to submit an application to the Awarding Organisation? *YesNoPlease see the relevant policies on https://mindbodywellness.org.uk/our-policies/Please upload a PDF version of your CV (or short CV summary) with highest level of education indicated, any fitness qualifications and brief career history * Click or drag a file to this area to upload. Do you have a current, up-to-date Emergency First Aid at Work (EFAW) certificate? *YesNoOther Phone a of If 'Other', please indicate what you have that might prove equivalence, such as an up-to-date nurse registration number on the NMC register.If you answered 'No', are you willing to organise enrollment on an EFAW day in your local area and upload the certificate to your your learner portfolio prior to the start of your teaching on the course?YesNoPlease upload a PDF version of any relevant instructor and/or first aid certificates Click or drag a file to this area to upload. Additional CommentsConfirmation that the information provided in ths application is true and correct *The information I have provided in this application form is true and correct.GDPR Consent *I consent.to having the secure Mindbody Wellness website store my submitted information so that the Mindbody Wellness tutor can respond to my application.You can read our Privacy Policy https://mindbodywellness.org.uk/privacy-notice/ to learn how we use your data. Our GDPR-compliant forms have been created with WPforms Pro which assigns a unique number to your form that does not allow storage of cookies.Your Signature (initials will suffice) * Clear Signature SubmitSave and Resume Later Your form entry has been saved and a unique link has been created which you can access to resume this form. Enter your email address to receive the link via email. Alternatively, you can copy and save the link below. Please note, this link should not be shared and will expire in 30 days, afterwards your form entry will be deleted. Copy Link Email * Send Link
