Professional Application for the Pole Fitness Association - Leading and Representing the Pole Fitness Community Worldwide

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Professional Application $49.99 (USD)

Note: The Submit Application button at the bottom will take you to the Pay Screen to complete your purchase.

(*) Required Field (#) Published Public Profile Field

First Name *#

Middle Initial

Last Name *#

Nickname (optional) #

Billing Street Address *

Billing City *

Billing State *

Billing Province/Territory

Billing Zip/Postal Code *

Billing Country *

Published City #

Published State #

Published Province/Territory #

Published Zip/Postal Code #

Published Country #

Phone Number *

Published Phone Number #

FAX Number

Email Address *

Published Email Address #

Date of Birth (Must be 18 years old) *

Professional Web Site URL #

Facebook URL #

MySpace URL #

Linked In URL #

YouTube URL #

Studio Affiliation #

Current Profession #
Studio Owner
Instructor
Student
Entertainer
Enthusiast
Other (Describe)

Years in Profession?
0-1
1-2
2-3
3-4
4-5
5-6
6-7
7-8
8-9
9-10
More than 10

What are your Professional Skills? #
Pole Fitness
Core Pole
Chinese Pole
Hip-Hop
Hula Hoop
Yoga
Gymnastics
Aerial Silks
Aerial Hoops
Chair Dance
Belly Dance
Boot Camp
Core Ball
Cardio Workout
Pilates
Ballet
Other (Describe)

Certifications/Accreditations #

Describe Services you Offer #

Biography # - What would you like the public to know about you and your profession?

Why did you join the PFA?
Marketing
Benefits
Networking
Insurance
Annual Conference
Standards
Support our Industry
Other (Describe)

How did you hear about us?
Google
Yahoo
MySpace
Facebook
Word of Mouth
Magazine
Web Article
Other (Describe)

Comments to the PFA

• For your professional photo, send a GIF, JPG or PNG formatted file to membership@polefitnessassociation.com.

Once you click the Submit button, you will not be able to come back and change your information. To submit changes, send them to membership@polefitnessassociation.com. Please allow one week for your Application to be reviewed and posted and 2-6 weeks to receive your membership kit.

If you are filling out this Application as part of a Studio Membership, please click the Submit button below for further instructions.

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