FIU-MMC Personal Trainer Request Form

Thank you for your interest in personal training at the FIU-MMC Wellness and Recreation Center! Please submit this form in its entirety. If you have questions about personal training, please contact Lindsey Meeks at (wrcfitness@fiu.edu).
Prior to completing the rest of this form; please acknowledge below that you recognize this is to request a personal trainer, which is a paid service through FIU WRC. *
Required
Name (First & Last) *
Your answer
Email Address *
Your answer
Phone Number *
Your answer
Gender *
Panther ID #
Your answer
Date of Birth (mm/dd/year) *
Your answer
Please select the category that best describes your current FIU status *
Please select the Personal Training Services you are interested in *
Required
How many days per week would you like to work with your trainer?
I prefer my trainer to be: *
Are you a returning Personal Training Client? *
How can a Personal Trainer help you? *
Required
Please list any prior medical conditions, questions, comments or concerns you may have about working with a personal trainer.
Your answer
Please list ideal times you would like to meet with your personal trainer (such as Monday before 8am or Tuesday after 6pm)
Your answer
If you have a preferred personal trainer, please list their name below.
Your answer
By submitting this form, I agree that I have reviewed the personal training prices and am interested in purchasing personal training services. *
Required
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