STOTT PILATES® Certification Online Application


Contact Information


Name:
Address:
City:
Province:
Postal Code:
Phone (day):
Phone (evening):
Fax:
Company Name:
Email:

Course Registration


Applications must be accompanied by 2 letters of reference and a $300 (+ HST) deposit (non-refundable). Space is limited and applications will be processed on a first-come, first-served basis. Space will only be reserved upon the receipt of all application materials and deposit. If you are applying online, your 2 letters of reference can sent by email, fax or mail. Click here for our contact information.

Cancellation Policy

All registration fees are due seven days prior to course start date. Please note that once payment and confirmation of the course have been made, there are no refunds.


Intensive Program


Course A Intensive Mat-Plus™ (40 hours) or IMP (40 hours)
Course B Intensive Reformer (50 hours) or IR (50 hours)
Course C Intensive Cadillac, Chair and Barrels (50 hours) or ICCB (50 hours)

Financial Information


I would like to make a:
I will be paying by:
Credit Card Number:
Expiration Date:
Name on Credit Card:

Relevant Education


Please list related degrees, diplomas, post secondary or certificate courses, and workshops:



Outline education in anatomy courses/workshops taken:



List related certifications, e.g. ACE, AFAA, etc. (please specify) :



Relevant Experience


Outline your teaching experience:



Describe your experience in the body movement, dance, and/or fitness field:



Outline your experience with the works of Joseph Pilates:



Personal Information


Do you have any injuries, conditions (including current or recent pregnancy), or postural issues that may affect your performance during the course?



How did you hear about Merrithew Health & Fitness™ and STOTT PILATES® Education?



How do you plan to use your certification (how will you be applying your knowledge)?



Are using this course to fulfill continuing education credits?
Do you require assistance locating accommodations in Halifax/Dartmouth?


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