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Personal Training Request Form - Campbell University
Please fill out this form if you are interested in obtaining information or register for our personal training program at Campbell University Campus Recreation. Any questions, please direct to Cora-Ann Licwinko at
What is your full name (first and last)
What is your best e-mail address to contact you at?
What is the best phone number to contact you at?
May we text you?
What is your affiliation to Campbell University?
COMMUNITY MEMBER (ANYONE ELSE, INCLUDES ALUMNI, NOT EMPLOYED OR CURRENTLY ATTENDING CU)
Main Interest for Personal Training
Healthier Life Choices
What is your preferred availability? (select all that could apply)
Early Mornings 6am-8am
Lunch Time (11am-1pm)
Early Evening (4pm-7pm)
Late Evening (7pm-10pm)
I acknowledge that I am being placed on a wait list until a trainer becomes available to meet with me?
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