1.First and Last Name

2.Email Address

3.Phone Number

4.Level of yoga experience

Beginner

Intermediate

Advanced

5.Attendance intentions

Weekly

Drop In

6.Do you have a specific goal? If yes, please explain.

7.Are you new to yoga through Self-Help Connection?

Yes

No

8.Have to participated in yoga through Self-Help Connection before? If yes,
approximately how many sessions?