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First Name*
Last Name*
Address*

Street Number, City, State and ZIP
E-mail Address*
Phone Number*
Occupation & Current Employer*
Are you full-time, part-time, or freelance?
Your Practice*
We recommend that you have a minimum of two years experience teaching meditation. Please be honest in answering the questions below, and do not fear answering “no.” Having this information will help us get to know you and ensure we’re able to find the best fit for you. How long have you been practicing meditation?
Do you practice other awareness based practices, such as yoga or Tai Chi? **
- Yes, frequently
- Yes, sometimes
- No
If yes, please list your practices:
If yes, where do you teach?
Are you currently teaching meditation?
Are you current teaching fitness/wellness?*
If yes, where and what do you teach?
Why do you want to be a Journey Meditation teacher?*
Peak times for Journey classes are Tuesday, Wednesday, and Thursday from 11AM-4PM. Do any of these times conflict with your current schedule?*
Are there any days and times that you are not able to teach?
Tell us a little more about you! What do you want us to know?
Name
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