Business Membership - Registration Form

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This form is to be completed by an existing qualified fitness professional or health professional.

Email *

First Name *

Last Name *

Mobile Phone *

What is your current role / profession? *

General Practitioner (Doctor)

Physiotherapist

Dietician

Exercise Physiologist

Chiropractor

Nutritionist

Physical Education Teacher

Personal Trainer

Sports Coach

Gym / Fitness Instructor

Group Fitness Leader

Other:

Provide details of any professional qualifications and relevant registrations

Fitness Professionals Only: Which of the following organisations are you currently registered with:

Fitness Australia

FitREP

Physical Activity Australia (PAA)

None

Other:

Clear selection

Do you have any questions or additional information that you would like to provide? *

A copy of your responses will be emailed to the address you provided.

Submit

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This form was created inside of National Coaching Institute.