Uplift - Mentorship Program Application

uplift.

A transformational mentorship program created and cultivated by The Sanctuary Yoga Room

Name *

Date *

Studio(s) teaching at: *

Why are you interested in this program and what do you hope to gain from it? *

200-hour completed with which studio and when? *

Where do you practice? *

Do you have time to commit to this journey (an estimated 3 hours of study a week)? *

When are you UNAVAILABLE to work with your mentor (including phone conversations, text)? *

What teacher, topics or skill set inspires you on the mat? *

What currently inspires you off the mat? *

What areas or domains are you looking to grow in the most? *

What does your physical asana practice schedule/home practice look like? *

List three goals you hope to achieve from this program? *

For mentor requests, please choose three mentors and rank in order from 1 to 3: Missy Shaw (e-RYT) / Lauren Lewkowicz (e-RYT, M.Ed + BCBA) / Kaci Ford (e-RYT) / Laura Tucker (e-RYT, LPC intern) / Rich Basler (e-RYT) / Dr. Whitney Myers (e-RYT) / Rebecca Emery (e-RYT, RMT, RMM) / Rebecca Butler (e-RYT, Life Coach / separate price of $2,000, schedule permitting) *

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