DPI Adaptive Fitness-Trainer Application
WORK DESCRIPTION: Application for a contractor position with DPI Adaptive Fitness-Work Duties include but are not limited to: working with the physically disabled population to enhance their adaptive fitness experience in small and large group or individual adaptive fitness sessions. Our adaptive trainers are required to motivate, encourage, and safely push our clients to perform. Training will be provided to ensure the applicant understands guarding techniques, transfers, and program designs to ensure safe programming for our adaptive clients. Our trainers are required to represent DPI Adaptive Fitness and themselves in a professional manner at all times.

**NCCA Accredited Fitness certification is preferred but not required, Active CPR Certification is required**
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Email *
After reviewing the above work description, do you feel you would be able to perform the essential functions of this job? *
Name *
Date of Birth *
Social Security Number
Address *
Phone *
Email *
Emergency Contact Name and Contact Number *
Coverage pool work options you would be available (select all that apply) *
Please describe your interest in working in an adaptive fitness gym environment? *
When are you available to start working *
Are you CPR certified? *
Are you an active certified personal trainer *
Which certification(s) do you currently have? (N/A if none) *
Are you liability insured as a certified personal trainer? *
Who is your coverage provider? (N/A if none) *
Please list your education history *
Are you currently authorized/eligible to work in the Unites states? *
Have you ever been convicted of a crime (A conviction record does not necessarily disqualify you from consideration) *
Have you ever been in the armed forces *
Please review before e-signing this application to complete
I hereby authorize the potential employer to contact, obtain, and verify the accuracy of information contained
in this application from all previous employers, educational institutions, and references. I also hereby release
from liability the potential employer and its representatives for seeking, gathering, and using such information
to make employment decisions and all other persons or organizations for providing such information.
I understand that any misrepresentation or material omission made by me on this application will be sufficient
cause for cancellation of this application or immediate termination of employment if I am employed, whenever
it may be discovered.

If I am employed, I acknowledge that there is no specified length of employment and that this application
does not constitute an agreement or contract for employment. Accordingly, either I or the employer can
terminate the relationship at will, with or without cause, at any time, so long as there is no violation of
applicable federal or state law.

We are an equal employment opportunity employer. We adhere to a policy of making employment decisions
without regard to race, color, religion, gender, sexual orientation, national origin, citizenship, age, height,
weight, or disability. We assure you that your opportunity for employment with us depends solely on your

Thank you for completing this application form and for your interest in our business.
Print name for e-signature after reading above and to ensure you have completed this application yourself *
Today's Date *
A copy of your responses will be emailed to the address you provided.
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