Become a Certified Personal Trainer!

Strength and Conditioning Personal Trainer Certificate

Student Interest Form

First Name   Last Name
Address
City
  State     Zip
E-Mail
Phone    Cell Phone
 
1.
I am interested in being contacted with information on classes and workshops related to this program.
2.
I have reviewed the Strength and Conditioning Personal Trainer Certificate Program and I plan on completing the full certificate program.
3.

I am considering completing the Strength & Conditioning Personal Trainer Certificate Program.
4.
I am interested in taking approximately classes per term.
5.
I am interested in taking summer courses.
6.
I am willing to take a class at another MCCCD college if a class is not available at a time that meets my needs (classes are offered at SCC, GCC, and MCC).
7.

My schedule allows me to take:
day classes   evening classes   weekend classes
8.
I would like to become ACSM Certified after completing this program.
9.
Please check other certifications that you would be interested in:
ACSM Health and Fitness Instructor Certification (American College of Sports Medicine)
ACSM Personal Trainer Certification
NASM Personal Trainer Certification (National Academy of Sports Medicine)
    NSCA Personal Trainer Certification (National Strength and Conditioning Association)
ACE Personal Trainer Certification (American Council on Exercise)
ACE Group Fitness Instructor Certification  
10.
I would be interested in taking additional courses to help me specialize in:
Seniors (60+)   Athletes Aquatics
Lifestyle Coaching   Operating my own business
Other:
11.
What past professional or personal experience do you have in the field of health and fitness that has contributed to your interest in this program?
12
What is your Education Background:
High School Diploma   College AA/AAS Degree:
College BS/BA Degree:   College MS/MA Degree:
    Other Degrees or Certifications:
13
How did you hear about our program?
.  
 
Click here to submit this form.    
For more information, contact Dale Heuser, 602-787-7276
or dale.heuser@pvmail.maricopa.edu
Last updated: July 14, 2008
Paradise Valley Community College- URL-http://www.pvc.maricopa.edu/fitness/PT_InterestForm_Cert_Program.html
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