Asha Yoga Therapy Center and School
Application/Contract for Enrollment in Asha Yoga Therapy Center and School Yoga
Teacher Training 200 Hour
Dear Yoga Teacher Student,
I am delighted that you are interested in taking the 200 Hour Yoga Teacher Training at Asha Yoga
Therapy Center and School. In this training you will grow and deepen your understanding of
yoga and ultimately yourself. The word Yoga come from the Sanskrit root yuj which means "to
yoke, to join, to unite". I believe that by it's very nature "Yoga" is therapy-the uniting of body,
mind and spirit. The essence of yoga is to come to know and accept yourself with compassion
and love. I am looking forward to taking this journey with you.
"All you need is love"
The Beatles
I graduated from Wayne State University 1984 with a Masters in Social Work. I worked for
several years at the VA Hospital in Allen Park and at Harper Hospital in their Chemical
Dependence Unit. I transitioned to my own private practice in 1988. In 1997 I received my PhD
in Clinical Psychology from the Union Institute and University in Cincinnati, OH and continue
to work in private practice.
I have been practicing yoga on and off since 1970. My commitment to yoga became crucial
when in 2010 I developed chronic pain in my hip which prevented me from doing any form of
"exercise". I was an avid runner and gym member for many years. The simple act of walking or
bike riding was unbearable even with large doses of ibuprofen. After several appointments with
various doctors I was told that my years of running, impact exercises and "arthritis" literally
wore off much of the cartilage in my hip joint and that I would need a total hip replacement.
About that same time, August 2010, Bodhi Seed Yoga opened it's doors! I found that this was
the only form of movement I could do without pain. I became a "regular" I practiced daily. In my
daily practice I was able to strengthen the muscles in my hips and thighs but still needed surgery.
I came to see an Orthopedic Surgeon who encouraged me to continue my yoga practice in order
to help with the recovery from the surgery. With the stillness of yoga I was able to find a calm
resolve in having the surgery. I had the surgery in December of 2010. I was back to work in 2
weeks and practicing yoga in 4 weeks. The transition was seamless and the pain meds were no
longer a part of my life.
From that point on I knew that yoga would be more than just a one hour practice. It would be a
way of life. I began to search for a Teacher Training program. Bodhi Seed Yoga began their first
Teacher Training in January of 2012 and I was in. I will be forever grateful to my teachers from
Bodhi Seed; June Hayes, Christie Cairo, and Pat Hill. I have also been trained in LifeForce Yoga
for Depression and Anxiety with Amy Weintraub. I received my 500 hour Teacher Training and
Yoga Therapy Training in 2013 at Seven Centers Yoga Arts in Sedona, Arizona.
While in my 200 hour training I began to envision the idea of a donation based yoga center. The
I taught our first class at Asha Yoga Therapy Center on May 4, 2012. We expanded the center in
November of 2014. As a student in this Training together we will continue to provide the
community access to the true meaning of yoga. Whether you decide to teach or not what you
learn here you will pass on to others just by your presence.
Atha Yoganuśāsanam
"Now we will follow along with the teachings of Yoga and honor them."
Yoga Sutra 1.1
Yoga Teacher Training Schedule: The training will be in two modules: October 2, 2015 through
December 12, 2015 (no classes the weekend of November 27-28) with a 2 week break between
the holidays, off December 18 &19 and 25 & 26. We will resume on Saturday January 2, 2016 to
February 27, 2016.
Classes meet on consecutive Saturdays from 10:00 am to 4:00 pm or 5:00 pm and every other
Friday from 5:00 to 8:00 pm or 6:00 to 9:00 pm, time will be determined by majority student
availability.
Please feel free to contact me if you have any questions at: 586-466-7173 or
drmaryjanegazda@me.com
Sincerely,
Mary Jane Gazda, PhD., E-RYT 200, RYT-500, CYT
Asha Yoga Therapy Center and School Teacher Training Application/Contract
Name:_____________________________________________________________
Address:___________________________________________________________
Home Telephone:________________________Cell Phone:__________________
E-mail address (if available):__________________________________
Month/day of birth: ___/____/XXXX (no year, please)
Emergency Contact:
Name:___________________________Telephone:__________________ Place of
Employment:_________________________________Position:_______________
Days and hours of employment:________________________________________
May we contact you at work?_______ if so, telephone number:_______________
Previous employment positions held:_____________________________________
__________________________________________________________________
Educational History/Schools Attended/Degrees/Curriculum:_________________
__________________________________________________________________
__________________________________________________________________
__________________________________________________________________
Certifications held:___________________________________________________
__________________________________________________________________
Hobbies/Interests:____________________________________________________
__________________________________________________________________
_________________________________________________________________
Tuition & Fees:
There is a $100 application fee to hold your place in the training; this amount applies to your
total payment. The total cost of the program is $2500.00. It includes all practice and lecture
sessions during the 19 week curriculum, a Training Manual and an Individual Ayurvedic
assessment and yoga practice. It also includes a weekend retreat with shared room, (single
occupancy- an additional $50.00). The retreat will be held at the Lake Huron Retreat Center in
Port Huron, MI, January 15-17, 2016. No books, lodging (excluding retreat) or travel expenses
are included in this price. During the duration of the training you will have “Unlimited Yoga
Classes”, this does not include *workshops or special events.
*Tentative workshop in January, which will meet on a Saturday and Sunday; “Fundamentals of
Yoga Anatomy” cost $80.00. More information to come.
Payment Plans: (Checks Only)
Checks payable to Mary Jane Gazda, PhD.
$2,500.00 – $100.00 deposit with application, deadline August 31, 2015.
$2400.00 due by September 25, 2015 or NLT the start of training
$2,625.00 – $100.00 deposit with application
$1010.00 by September 25, 2015 or NLT the start training.
Three (3) payments of $505.00 due on or before: 10/25/15, 11/25/15, 12/25/16.
Timely payments required to ensure continued participation in the training.
Program Refund Policy:
The tuition and fees paid by the applicant shall be refunded if the applicant is not admitted to the
training. An application fee of $25.00 may apply if the application is denied. All tuition and fees
paid by the applicant shall be refunded if requested within three (3) business days after signing a
contract with the school. All requested refunds will be returned within thirty (30) days. Once the
three (3) business days have elapsed the following policy will apply: once the program starts, no
refunds are granted.
Pre-requirements & Application:
Upon submission of this application a brief meeting will be scheduled with Mary Jane Gazda,
Lead Teacher to review your application, your essay, your ability to commit to time required for
classes, assignments, practice time, and ability to meet financial requirements. A deposit of $100
will be required to hold student placement which applies to student tuition.
Please attach a separate page of a short essay on the reasons why you would like to take this
yoga teacher training course. Also include your previous yoga experience, why you started
practicing yoga and any interest or special talents you bring to your practice. A regular yoga
practice of at least 6 months is highly recommended prior to teacher training. Job placement
services are not part of this program.
How long have you been practicing yoga?___________________ Do you have a preference for
Yoga class/style when attending classes, and if so, what style?
______________________________________________________________________________
______________________________________________________________________________
This program requires 180 classroom/contact hours. In addition to 20+ non contact hours
including readings and homework assignments, a mandatory retreat at The Lake Huron Retreat
Center, January 15-17, 2016. There may be additional non-contact/individual/homework work of
over 20 hours.
Are you able to commit to attending sessions of 3-4 hours every other Friday and 6 hours on
Saturday, the 20 non contact hours plus, and attending the Retreat? ________________
During your training you are asked to refrain from using any mood or mind altering drugs to
include alcohol, marijuana, or other street drugs. Please continue to take any prescribed
medications as needed. Are you able to make this commitment? __________________
Please list any injuries or medical concerns:_______________________________
__________________________________________________________________
__________________________________________________________________
How will you pay for the training? In Full:______ Payment Plan:______
Grading System:
Grading system is complete or incomplete. Any incomplete may be made up according to the
Attendance policy below.
Attendance Policies:
In order to meet Yoga Alliance’s Requirements, students must attend 180 hours of class time
required. To meet the requirements of the Yoga Alliance, all classes must be attended in full. Any
class or portion of classes must be made up at a future date within two months of the date
missed. There will be an additional fee if a student needs to make up more than one session or if
the make up session is after the end of the training. All non contact requirements (homework,
projects and other assignments) must be completed, submitted and approved by the Lead Teacher
in order to complete the program and receive a certificate of completion. Any missed
assignments must be submitted within two months of end of training. Students are required to
arrive on time for each session and remain till the end of the training day. More than 3 late
arrivals or departures may require a make up.
Graduation Requirements:
Students must fulfill the required hours determined by the Yoga Alliance for the 200 hours yoga
teacher training: contact and non contact assignments completed, submitted and approved;
completion of all tests and quizzes in the program; full payment of tuition; any and all materials
borrowed from the center returned. Additionally students must demonstrate an understanding and
proficiency of the teachings through their practicum and written assignments. Grading is based
on completing the program (all requirements met = certificate of completion). Students are also
required to attend one to two classes per week taught by Mary Jane Gazda or Cindy Neville
during the training weeks as part of the contact hours required by the Yoga Alliance, for a total of
25 classes. Please review the Asha Yoga's class schedule. (There are 19 weeks in the program in
which these classes are covered)
The days and classes that Mary Jane Gazda and Cindy Neville teach are:
Mondays: 7:00 pm Cindy
Tuesdays: 12:30 pm Mary Jane
Thursdays: 5:00 pm and 7:00 pm Mary Jane
(Schedule subject to change)
If unable to attend the classes at Asha Yoga, you can fulfill the requirements by attending Cindy
Neville's classes at Santosha or Christie Cairo's yoga classes either at Bodhi Seed or Santosha
Yoga. There is an additional fee charged by that yoga studio. Ask for details if necessary.
Students are required to teach 4 feedback classes to the public, with at least 2 being taught with
the Lead Teacher present. Your class must be one hour in length, contain a philosophical theme
and begin with a brief meditation. Students will have participants complete a written feedback
questionnaire which will be provided. The required styles of yoga are as followed:
~Ashtanga (modified short form), ~Slow Flow, ~Basic Mixed, ~Yin.
Certification:
Asha Yoga Therapy Center and School Teacher Training satisfies the entire requirements for the
200 Hour Yoga Teacher Training as required by the Yoga Alliance (a national registry for yoga
schools) certification. You will become equipped with the necessary knowledge, experience and
confidence to teach yoga in the community and private sector. You will receive a Certificate of
Diploma upon completion and be eligible to become a Registered Yoga Teach (RYT) through
Yoga Alliance at the 200 hour level. Placement assistance is not available for students.
Additional information about Yoga Alliance may be found at:
www.yogaalliance.org.
Teachers and Guest Speakers: (Guest teacher may change due to availability)
Mary Jane Gazda, PhD,- E-RYT 200 RYT 500- Lead Teacher
Jasmine Cromwell, CYI, NC (Nutrition Consultant), PCD (Certified Postpartum Doula)
Cynthia Neville-RYT-200
Additional Required Materials:
~One (1) yoga mat, meditation cushion if needed.
~One or two lined and perforated notebooks for notes and writing assignments.
~Pens or pencils, highlighters, bookmarks etc.
~Saturday sessions will require a packed or purchased lunch/snack and/or beverage. Book bag or
whatever you prefer that will allow you to bring the above items to class.
Student Code of Conduct:
1. Please arrive on time for all classes.
2. Bring your own yoga mat to class.
3. Props such as blocks, straps and blankets will be available for student use.
4. All cell phones must be turned off. You may use an iPad or Laptop but it must be on
silent.
5. Please keep you space clean and put all props, etc. away.
6. Make sure that you have all books and supplies required for the class.
7. Please respect your fellow students and treat them as you yourself would like to be
treated.
8. Keep perfume and any scents at a minimum to respect those with allergies.
9. Please dress in comfortable and appropriate clothing for the class and asana practice.
10. Students who do not follow these policies may be dismissed with no refunds given.
Mail or drop off your application along with your $100.00 registration fee.
Make checks payable to Mary Jane Gazda, PhD.
Asha Yoga Therapy Center and School
36393 Harper Avenue
Clinton Twp., MI 48035
586-466-7173
I have read the above application and I agree to the terms and conditions as stated above:
Signature:__________________________________________________________Date:_______
_____________
Approval of application:
Signature of LeadTeacher:_____________________________________________
Date:________________
List of Required texts will be provided at your individual meeting.
References/Required Texts: (Required text not included in the cost of the
tuition)
The Yoga Sutras of Patanjali, by Sri Swami Satchidananda; Integral Yoga
Publications, Buckingham, Virginia; 2010
The Heart of Yoga; Developing a Personal Practice, by T. K.V. Desikachar; Inner
Traditions International, Rochester, Vermont; 1995
Ashtanga Yoga; The Practice Manual, by David Swenson; Ashtanga Yoga
Productions; Houston, Texas; 1999
Hatha Yoga Illustrated; for greater strength, flexibility and focus, by Martin Kirk,
Brooke Boon and Daniel DiTuro: Human Kinetics, Champaign, Illinois; 2006
The Complete Guide to Yin Yoga: The Philosophy and Practice of Yin Yoga; by
Bernie Clark; White Cloud Press; Ashland Oregon; 2012
The Key Muscles of Yoga: Scientific Keys:Volume 1, by Ray Long and Chris
MacIvor; Bandha Yoga Publications; 2006
Trial Guide to the Body Flash Cards, Volume 1: Bones, Ligaments and Movements
of the Body, By Andrew Biel; Books of Discovery; Boulder, Colorado; 2010
Trail Guide to the Body Flash Cards, Volume 2: Muscles of the Human Body, by
Andrew Biel; Books of Discovery; Boulder, Colorado; 2010.
The Wisdom of Yoga, A Seeker's Guide to Extraordinary Living, by Stephen Cope;
Bantam Books; New York, New York; 2007.
References/Suggested Reading (not required)
Hatha Yoga Pradipika, by Swami Muktibhananda; Yoga Publications Trust;
munger, Bihar, India; 2010.
Light on Yoga; by B.K.S. Iyengar; Schocken Books; New York, New York; 1966.
Spirit of Yoga, by Cat De Rham and Michelle Gill, Thorson; Hammersmith,
London; 200.
The Language of Yoga, A complete A to Y Guide to Āsana Names, Sanskrit Terms
and Chants, by Nicolai Bachman; Sounds True; Boulder, Colorado; 2005.
The Living Gita, The Complete Bhagavad Gita, by Sri Swami Satchidananda;
IntergalmYoga Publications; Yogaville, Virginia; 2010.
The Yamas & Niyamas; Exploring Yoga Ethical Practice, by Deborah Adele; Onword Bound Books; Innovative Publishing; Duluth, Minnesota; 2009.
Wherever You Go There You Are, Mindfulness Meditation in Everyday Life,
by Jon Kabat-Zinn; Hyperion; New York, New York; 1994.
Yin Yoga Outline of a Quiet Practice, by Paul Grilley; White Cloud Press; Ashland,
Oregon; 2002.
Yoga Anatomy (Second Edition); by Leslie Kaminoff and Amy Matthews; Human
Kinetics; Champaign, Illinois; 2012.
Yoga and the Quest for the True Self, by Stephen Cope; Bantam Books; New York,
New York; 2000.
(All books can be purchased at Amazon.com in new and used condition.)
There will be many more books that I will talk about during the training. Again not
required but some you may be interested in.