First Name

Last Name

Email

Address

Phone

City

State

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Zip Code

Program of Interest

Ayurvedic Wellness Counselor (AWC)Ayurvedic Wellness Practitioner (AWP)

Program Date

Spring 2019Fall 2019

Program Format

In-classOnlineNot sure

Do you have any interest in coordinating a local class?

NoYes

Educational Background

Check all that apply
High School Diploma/GEDBachelor's DegreeMaster's Degree or higherSpecialty Certification(s)

Please describe any specialized areas of study and your work experience

How did you become interested in Ayurveda?

What do you hope to gain from this training?

Do you have experience with the following?

Check all that apply
WritingEditingCopyeditingMarketingPhotographyVideographyFilm EditingGraphic DesignSocial MediaResearchProject ManagementEvent PlanningEvent CoordinationExhibition Events & BoothsProduct InventoryEcommerceCookingNutritionYoga

Is there any additional information you would like to share?

Please upload your resume

Please confirm your agreement to the terms of this application

I confirm that all experience and skills shared in this application are accurate to my identity and capabilities. I apply with full intention of enrolling in an upcoming program. I am capable of meeting the required minimum 17 hours of work during my scheduled course if accepted into the work study program.

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