First Name: * Last Name: * Phone Number to be reached at: * Email: * What is your profession and/or background in health, fitness or education? List any relevant certifications or course work. * What other experience do you have that you feel would be beneficial in leading Enhance Fitness? (Work with people with disabilities, older adults, people with special needs, fitness or professional experience). * If you are a fitness professional, what current certifications do you have? * Is your CPR/AED certificate current? * Yes No What is your primary interest in this position? * What areas are you able to teach in? * Washtenaw County Livingston County Macomb County St. Clair County Flint Grand Rapids Oakland County Wayne County What time of day are able to teach? * Are you interested in leading EF demonstrations in the evenings or weekends? * Have you been a participant in Enhance Fitness? * Yes No If you answered yes to the question above, where was your EF class located? How did you hear about this opportunity? * Local paper Newsletter Volunteer Website NKFM Website Referral from current instructor or participant Healthcare provider Other If referred by an organization or individual, please list: Briefly describe your experience with laptops or tablet computers: * Are you fluent in a language other than English? * Yes No If you answered yes to the question above, what other language are you fluent in? By signing below, I certify that the application information is correct. * Today's date: * Leave this field blank
