STOTT PILATES® Certification Online Application

Registration Details

Applications must be accompanied by 2 letters of reference and a $300 (+ HST) deposit (non-refundable). Space is limited and applications will be processed on a first-come, first-served basis. Space will only be reserved upon the receipt of all application materials and deposit. If you are applying online, your 2 letters of reference can sent by email, fax or mail. Click here for our contact information. Certification course fees.

Cancellation Policy

All registration fees are due seven days prior to course start date. Please note that once payment and confirmation of the course have been made, there are no refunds.

Contact Information

[contact-form to=’info@interludefitness.com’ subject=’STOTT PILATES Certification Online Application’]

[contact-field label=”Name” type=”name” required=”true” /]
[contact-field label=”Email” type=”email” required=”true” /]
[contact-field label=”Address” type=”address” required=”true” /]
[contact-field label=”City” type=”city” required=”true” /]
[contact-field label=”Province” type=”province” required=”true” /]
[contact-field label=”Phone (day)” type=”phone_day” required=”false” /]
[contact-field label=”Phone (evening)” type=”phone_evening” required=”false” /]
[contact-field label=”Company Name” type=”company_name” required=”false” /]
[contact-field label=”Fax Number” type=”fax” required=”false” /]

Intensive Program

Select the program(s) you want to register for:

[contact-field type=”checkbox” label=”Course A Intensive Mat-Plus™ (40 hours) or IMP (40 hours)” /]
[contact-field type=”checkbox” label=”Course B Intensive Reformer (50 hours) or IR (50 hours)” /]
[contact-field type=”checkbox” label=”Course C Intensive Cadillac, Chair and Barrels (50 hours) or ICCB (50 hours)” /]

Payment Information

[contact-field label=”For my registration of deposit ($300 +HST), I will pay by:” type=”select” options=”Visa, Mastercard, Amex, Cheque by mail” /]

[contact-field label=”Name on credit card” type=”cc_name” /]
[contact-field label=”Credit card number” type=”cc_number” /]
[contact-field label=”Expiry date (MM YYYY)” type=”cc_expiry” /]

Relevant Education

[contact-field label=”Please list related degrees, diplomas, post secondary or certificate courses, and workshops:” type=”textarea” required=”false” /]
[contact-field label=”Outline education in anatomy courses/workshops taken:” type=”textarea” required=”false” /]
[contact-field label=”List related certifications, e.g. ACE, AFAA, etc. (please specify)” type=”textarea” required=”false” /]

Relevant Experience

[contact-field label=”Outline your teaching experience:” type=”textarea” required=”false” /]
[contact-field label=”Describe your experience in the body movement, dance, and/or fitness field:” type=”textarea” required=”false” /]
[contact-field label=”Outline your experience with the works of Joseph Pilates:” type=”textarea” required=”false” /]

Personal Information

[contact-field label=”Do you have any injuries, conditions (including current or recent pregnancy), or postural issues that may affect your performance during the course?” type=”textarea” required=”true” /]
[contact-field label=”How did you hear about Merrithew Health & Fitness™ and STOTT PILATES® Education?” type=”textarea” required=”false” /]
[contact-field label=”How do you plan to use your certification (how will you be applying your knowledge)?” type=”textarea” required=”false” /]

[contact-field label=”Are using this course to fulfill continuing education credits?” type=”select” options=”Yes, No” /]

[contact-field label=”Do you require assistance locating accommodations in Halifax/Dartmouth?” type=”select” options=”Yes, No” /]

[/contact-form]