Preceptor Application

Thank you for your interest in becoming a preceptor. Yoga Veda Institute appreciates your willingness to participate in the practical education of the future of Ayurveda.

Name*
First Last
Title
CV/Resume*
Accepted file types: pdf, doc, docx, Max. file size: 300 MB.
Office Phone*
Cell Phone (optional)
Business Email*
Alternate Email (optional)
Site Name
Site Information*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Please provide a brief description for your site and the activities your students will be participating in. This information is valuable to students as they seek to select sites and preceptors that best align with their future career goals.*
Please list the days and times you have in mind for your preceptorship.*
Describe why you wish to participate in the training of future Ayurvedic Health Counselors and Practitioners? How do you see your role as a preceptor?*
Are you a preceptor for other Ayurvedic programs?*
- Yes
- No
If you answered "yes" to the question above, what other programs do you take students from?
Degrees and Education*
Please list any degrees and certificates you have earned below (Degree/Certificate Name, School, Graduation Date)
Have any students already approached you to become their Preceptor? If yes, please provide the first and last name of the student(s).