Student Questionnaire Select Options Confirm Options Checkout Receipt Questionnaire Please complete this questionnaire and then submit it by clicking on the submit button below. We'd like to receive the form sooner than later, as this form helps us to organize homerooms, plan for exceptions and preferences, and give you the best possible learning experience we can! Note that items marked with an asterisk must be answered or the form will not allow you to send it! Name* First Last Email* Phone numberMobile numberI am a*MaleFemaleAge*Profession/Area of Study*Previous study of the Alexander TechniquePlease be specific so we can place you in an appropriate group. Previous study of YogaPlease be specific so we can place you in an appropriate group. Previous study of AyurvedaPlease be specific so we can place you in an appropriate group. Are you an Alexander Technique Teacher or Teacher Trainee?NoTeacherTraineeYears of Training CompletedOne (1)Two (2)Three (3)School where you trained or are trainingOther interestsFor example, fine arts, performance arts, athletics, martial arts, etc.Further CommentsAny more information about your condition, experience, etc. that will help us in working with you as a student.Special RequestsPlease add any additional information or special requests that would aid us in understanding your situation.How will you be travelling?CarPlaneOtherUndecidedEarly or Late Arrival Comments If you plan to arrive a day or more early or leave a day or more late, please tell us what your plans are. How did you find out about the workshop?* From a friend Brochure Postcard Google, Yahoo, etc. online ad Online search Another website From my Alexander Technique teacher I already knew Other Who is your Alexander Technique teacher?On which website did you find us? Please elaborate on how you found the workshopPhoneThis field is for validation purposes and should be left unchanged. This iframe contains the logic required to handle AJAX powered Gravity Forms.
