New Member Platinum Registration (College and University Grads) 2 Year membership with Insurance Subscription

Please enter information on the form below to process subscription for New Member Platinum Registration (College and University Grads) 2 Year membership with Insurance.

Username*

Password*

Retype Password *

First Name

Last Name *

Organization

Address *

Address2

City *

Postal Code *

Country *

Province *

Phone

Fax

Email *

Comment

Qualification 1 (You must confirm by checking this box) *

qualified by an OFC TFL (at an Ontario College, or University)

Qualification 3 (You must confirm by checking this box) *

Has at least 1 certification (ex. Group Exercise OR Aqua Fitness) and a minimum 2 year college diploma in Fitness and Health Promotion or a degree in health sciences

Payment Information

Coupon

Price

Discount Amount

Gross Amount

Payment Method

Paypal or you may use your credit card also.

Credit Card Number*

Expiration Date*

Card (CVV) Code*

Card Holder Name*

By checking this box I confirm I have read the terms and conditions and I accept them

Security Code*

New Member Platinum Registration (College and University Grads) 2 Year membership with Insurance Subscription

Existing user? Please login

New User? Please register

Account Information

Payment Information