Strength Training Workouts That Work!       


Instructor Registry for instructors teaching Geri-Fit® and/or Geri-Flex®

Full Name:
Address:
City: State: Zip:
Phone:
Email Address:
Days Preferred: Monday & Wednesday
Tuesday & Thursday
Monday & Thursday
Wednesday & Friday
Tuesday & Friday
Saturdays
Sundays
Times Preferred
(your best hours to teach):
Mornings:
Afternoons:
Evenings:
List three cities where you would
like to teach class, or the location(s)
where you will be teaching:
Yes No Have you ever taught an exercise class before?
If yes, where:
Yes No Do you have any present exercise instructor certifications?
If so, which one(s) - Organization / Exp. Date:
Yes No Are you registering on behalf of a licensed organization?
If yes, where:
Additional Comments: