TantratoLove™ Immersion + Educator Application

Name *

First Name

Last Name

Phone *

(###)

###

####

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Do you feel you will be able to commit to attend all the scheduled classes? *

Yes

No

If you answered "yes", which immersion will you attend? *

In person Jaunary 7th to February 11th, 2023

Virtual January 7th to February 11th, 2023

Private Mentoring (15 Zoom or in person sessions)

Are you planning to get certified? *

Yes

No

If yes, will you want Yoga Alliance CEUs? *

Yes

No

First and Last Name Electronic Signature *

First Name

Last Name

Today's Date: *

MM

DD

YYYY

I undesrtand that checking this box constitutes a legal signature confirming that I acknowledge and agree to the above Terms of Acceptance. *

I agree