Ayurveda Program Application - Asheville School of Massage and Yoga

Thank you for your interest in attending the 600-hour Ayurveda Wellness Counselor Program

For Best Results Before Getting Started: Scan the form below to prepare your documents. Be in an uninterrupted environment & where you WON'T lose internet connection. Prepare answers to the short essay questions. Get Professional Reference & Personal Reference Information (Their name, phone number, professional license ID numbers) Take photos w/ your smartphone & email them to yourself of your Proof of ID (drivers license etc) and Proof of Education (GED, HS Diploma, etc). Prepare to pay the application fee $50

Date of Application*

Applicant Information

Name*

First Last

Address*

Street Address City State / Province / Region ZIP / Postal Code Country

Primary Phone*

Secondary Phone

Email*

Social Security Number

Date of Birth*

Birth City / State

Emergency Contact Information: Contact Name*

First Last

Emergency Contact Phone Number*

Emergency Contact Relationship*

Citizenship*

US Citizen
Non-US Citizen

US Citizen Current State of Residence OR Non-US Citizen Visa issued by:*

If US Citizen, enter State of Residence. IF Non-US Citizen, enter where Non-US Citizen Visa is issued by.

Have you ever been convicted of a felony or misdemeanor (excluding traﬃ c violations)?*

No
Yes

Felony information

Good Start!

Professional Information

Current Occupation*

Previous Occupation*

Previous Education*

High School
GED Certificate
College

Number of years college

PERSONAL REFERENCES

Personal Reference: Name*

First Last

Personal Reference Address

Street Address City State ZIP Code

Personal Reference Phone*

PROFESSIONAL REFERENCES

Professional Reference Name & Title (Licensed Massage Therapist, Physician, Yoga Instructor, etc.)*

Professional Reference Address

Street Address City State ZIP Code

Professional Reference License Number

Professional Reference Phone*

Where did you hear about the Asheville School of Massage & Yoga?*

Word of Mouth
Mountain Xpress
Internet
Facebook
Twitter
Other

Other: Heard about us...

Getting there...

PRIOR/CURRENT PROFESSIONAL INFORMATION

(if applicable)

Professional Title Date Begun

License/Registration # Type Expiration Date

Professional Title Date Begun

License/Registration # Type Expiration Date

List additional professional training/certiﬁcates received

PLEASE ANSWER THE FOLLOWING QUESTIONS.

How did you hear about the Asheville School of Massage & Yoga?*

Do you have a regular yoga and/or meditation practice?*

Do you agree to meet for a pre-admission interview (also possible to do over the phone)? List days and times available.*

Do you have the ability to ﬁnance your education? Which payment option are you interested in?*

Have you ever been charged with or convicted of a crime? If yes, please explain.*

Do you currently have health issues? If yes, please explain*

Please describe your interest in Ayurveda. What are your personal and professional goals as a student of Ayurveda?*

Moving On...

Student Application Checklist

In addition to your application, please submit to the school the following items: Proof of Age, College or High School Diploma

Proof of Documentation*

Upload: I'll upload them now below. (PS It's very easy to photo the documents with your smartphone, email them to yourself, & upload them now!)
Snail Mail (Asheville School of Massage & Yoga 707 Haywood Rd. Asheville NC 28806
Email: Subject Line "Student Application YOURNAME files" to [email protected]"

Check here if you're choosing to snail mail or email these items in.

Proof of Age (copy of Driver’s License or Birth Certiﬁcate) PS: It's very easy to use your phone to photo this document, then email it to yourself and upload it here.

Proof of Education (HS Diploma or GED) PS: It's very easy to use your phone to photo this document, then email it to yourself and upload it here.

Payment for Application Fee

Payment Choices*

To pay application fee

Final Notes:

Once the school has received your application and all of the items listed above, a school oﬃcial will call you to arrange an interview to complete the admissions process. If you are accepted to the program, an oﬃcial letter of acceptance will be sent to you after your interview. Call us to ensure we've received everything. 828.252.7377. 707 Haywood Road, Suite #001, Asheville, NC 28806 | (828) 252-7377 | www.AshevilleMassageSchool.org

Name

This field is for validation purposes and should be left unchanged.

Our Address:

or fill this form out below to Submit Online:

Ayurveda Certification Application

Thank you for your interest in attending the 600-hour Ayurveda Wellness Counselor Program

Applicant Information

Good Start!

Professional Information

PERSONAL REFERENCES

PROFESSIONAL REFERENCES

Getting there...

PRIOR/CURRENT PROFESSIONAL INFORMATION

PLEASE ANSWER THE FOLLOWING QUESTIONS.

Moving On...

Student Application Checklist

Payment for Application Fee

Final Notes: