IWA PRIVATE COURSE REQUEST FORM

Please print out this form and fax it to us at (440) 933-3800, or mail it to the address below. We will contact you to confirm the details.

Contact Person:
_____________________________________________________

Name of Facility:
_____________________________________________________

Address:
_____________________________________________________

City/State/Zip:
_____________________________________________________

Phone:
_____________________________________________________

Fax:
_____________________________________________________

Email:
_____________________________________________________

Course Requested:
Weight Training for Rehab, Function and Fitness (CWT)
Strength Training Program Design (STS)
Strength Training for Seniors (C.S.S.T.)
Functional Exercise Training (FET)
Pilates Fundamentals for Rehab, Function and Fitness
Pilates on the Ball (POB)
An Introduction to Yoga

Course Date Requested:
_____________________________________________________


IWA, Inc. | 31723 Leeward Court | Avon Lake, OH 44012
440-933-3890 | 1-800-WEIGHTS | FAX: 440-933-3800