SAIL Mailing List & Survey
Please respond to the items below to help us: keep you informed of our training program developments, b) share information on scheduled online sessions and c) survey prospective trainees about their interests and needs.
* Required
First Name
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Last Name
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E-Mail address
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Please be sure to enter the address accurately and use one that you read regularly!
(Area Code) Phone Number
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Daytime phone - Please include area code
Which state/country do you reside?
(Example: WA/USA)
Do you possess an exercise/fitness/personal trainer certificate
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Are you providing training or exercise/fitness/personal trainer services in a position that requires special qualifications?
Yes
No
Working on certification
If yes, describe you qualifications/relevant experience
Describe you qualifications for providing fitness/exercise training.
Do you possess an academic degree in exercise science or related field (e.g. Physical/Occupational/Recreational Assistant or Therapist or other Health Science discipline?
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Are you providing training or exercise/fitness services in a position that requires a college degree?
Yes
No
Working on an academic degree
If yes, describe you academic degree and relevant experience
Describe the educational experience that prepared you for providing fitness/exercise training.
Are you associatred with an Exercise/Fitness/Health Care/Aging Service site or organization that is interested in S.A.I.L. classes ?
*
Choose a response...
Yes
No (skip next 3 questions)
Exercise/Fitness site or organization:
Enter the name of the organization that you are affiliated with.
Exercise/Fitness site coordinator/supervisor at that site or organization:
Enter the name of your supervisor or leader
Exercise/Fitness site coordinator/supervisor Phone Number
Please enter the area code and phone number of the person identified in the previous question.
Which of our current training activities are you interested in?
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Fitness Instructor - $130 fee
OT/PT Professional Development - $190 fee
Pierce College credit course - normal tuition and fees
Just the two training activities
All of the above
Rate the value taking this training in an online mode.
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1 being low value because it is the only way the training is available to you and 7 being highly interested because it fits your learning style/needs/etc.
1
2
3
4
5
6
7
Low Value
High Value
Have you ever taken an online class or are you familiar with online learning?
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Yes
No
Don't Know
How did you hear about this program?
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Supervisor
Co-Worker
Friend
Instructor
Department of Health
Other:
Do you have any questions/comments/related training needs you'd like to see?