application – Authentic Pilates Learning Center

COMPREHENSIVE PROGRAM

Teacher Certification Application

To begin the program, students must demonstrate proficiency at the intermediate level and be able to apply the principles of Pilates. An assessment by a teacher trainer is required for admission.

Return to: Authentic Pilates Learning Center:
1Lethbridge Plaza, Rt. 17 North, Suite 34B, Mahwah, NJ 07430

Personal Information

Last name

First name

Address

City

State

Zip code

Cell number

Work number

Email

D.O.B

Highest Education Degree Completed

Sex (F/M)

Famale Male

Pilates Experience

How long have you been taking Pilates? Where do you practice?

How many sessions have you had to date? (Please specify privates, semi-privates and/or group classes)

What are your Pilates goals?

Do you have teaching experience? (Pilates, group fitness, yoga, etc.)

How many hours a week do you intend to apprentice?

Medical History

How long have you been taking Pilates? Where do you practice?

Excellent Good Fair Same Challenges

(Please explains any challenges)

Do you have any injuries that might affect your ability to fully participate in the training? If so, please describe.

Have you had any surgeries in the past year?

Is there anything else about your medical history and /or personal health that you would like us to know?