David Garrigues

In-depth study program application

Full Name: *

Age: *

Mailing Address: *

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

Email: *

Phone Number: *

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Occupation: *

Education Level:

Your experience practicing yoga:

Your experience practicing Ashtanga Yoga, including teachers in the lineage you have studied with and for how long:

Describe your current practice:

Describe personal reasons for wanting to attend this course:

Please provide any additional background or current information about you that you would like to share, or that may be helpful for David to understand your interest in this course.

Please provide location and dates of the in-depth study you wish to attend: *

April 26- May 6, 2012 - Ashtanga Yoga School of Philadelphia, Philadelphia, PA

June 10th- June 16th, 2012 - The Bandha Room, Olympia, WA

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