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Pilates Course Online Application

The Australian Pilates Acadamy

Welcome to the Online Registration Form

Please Fill out this On-Line-Registration to indicate your interest in a particular course.
  This form is intended for those who are registering for a course
If you are enquiring about a course, please click here.
Name:
 *
Email Address:
 *
Address:
  
Address Line 1:
 *
Address Line 2:
City:
 *
State:
Post Code:
Country:
Phone Number:
 *
Mobile:
*
  Please Select the Primary Course of Interest and its location and Relevant Start date
Preferred Interested Course:
  
Select Course*
Select Location*
  Please Select any other Courses of Interest (Leave blank if Not Applicable)

Additional Interested Courses:

 
Select Course
Select Location

Additional Interested Courses:

 
Select Course
Select Location
Start Date
  Please Select Workshops of Interest, its location and Relevant Start date (Leave blank if Not Applicable)

Interested Workshops:

 
Select Workshop
Select Location

Interested Workshops:

 
Select Workshop
Select Location
Start Date
*Qualifications:
Pilates Experience:
Current or Previous Injuries :
   
I accept the terms and conditions: *
     
     
If Payment is not made in full what is the preferred Payment Method for Balance: *

Credit Card. For security purposes we will contact you to process payment.
Cheques. Please send to:

44 Kundabung St,
Belimbla Park,
NSW 2570
Bank transfer (internet banking):

Commonwealth Bank
Account name: Body Fit Australia
BSB: 062 424
Account Number: 1021 8899

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