Sivananda Ashram Yoga Farm
Application Form

Note: Applications are confidential and reviewed only by senior staff. When you submit the application, the information is emailed to a recipient at the ashram and to the email address you provide. After review of your application, you will be contacted for an interview.

Please indicate the start date and end date of your visit. Be aware that the ashram prefers work study terms to begin on the first or the fifteenth of the month.
 Start Date
End Date
First Name:
Last Name:
Spiritual Name (if any):
Street Address
City
State/Region
ZIP/Postal Code
Country
Email Address:
Telephone (Day)
Telephone (Evening)
Time Zone
Age
Gender
 Male Female
Date of Birth (mm/dd/yyyy)
How did you hear about us?
In Case of Emergency Contact (Name)
Emergency Contact Address
Emergency Contact Telephone
Emergency Contact Relationship
Other Emergency Contact
Marital Status
Profession
Education (formal, informal or specialized)
Work Experience/Skills
 carpentry/building
gardening
cooking
cleaning
plumbing
sewing
grounds
office
computers- general
web design
graphic design
accounting
car repair
other (see below)
Other
Please list three (3) personal references including name, phone number and occupation. Kindly press return after each one.
If affiliated with any religious groups, which are they?
Yoga & Meditation Experience? (include names of teacher's systems, and include teacher training dates and locations.
Select how regular your yoga practice is.
 Never
once a week
2-3 times a week
5-7 times a week
a few times per month
Select how regular your meditation practice is.
 Never
once a week
2-3 times a week
5-7 times a week
a few times per month
Kindly list any ailment or physical or mental limitations that we should know about.
If you are interested in advancing your practice of yoga postures and meditation, specifically how would you like to do this?
If you have a criminal record, please provide details.
If you are currently using any prescription or recreational drugs, please describe your history of drug or alcohol use.
If you have ever suffered from any mental illness or been in a mental institution, please explain
If you have any special dietary needs or restrictions, what are they?
If you are a member or have been a part of a Sivananda Ashram or Center, which one?
Are you able to work independently and willing to do the duties assigned to you?
 Yes No
Are you ready to learn new skills and help in areas you are not familiar with?
 Yes No
Are you able to take directions?
 Yes No
Are you willing to open yourself to new ideas and teachings?
 Yes No
Is there anything else we should know or that you would like to tell about yourself?
Please write a brief explanation of your understanding of Karma Yoga and your reasons for wanting to come to the Ashram, including what you hope to achieve during your stay with us.
I, (insert name) agree to be in a yoga immersion program of the Sivananda Ashram Yoga Farm.
 Yes No

 

 

The Sivananda Ashram Yoga Farm is a 501(c)(3) volunteer-based non-profit organization (530) 272-9322/(800)469-9642 - 14651 Ballantree, Grass Valley, CA 95949 - yogafarm@sivananda.org
Website design and programming by Rob Hecker