|
A single person can enroll
in this program for just $199. Special
only $59
Two people can enroll at the same time
and receive a discount. The total price for two people is
just $349. Special
only $79
|
1. You can print our form and send
it in by fax or mail.
2. Call us Monday - Friday toll free 1-877-348-6692 List
of extensions
3. Click
here to order immediately "SECURE" online,
24 hours a day (You will be transfered to the NESTA website).
Please read the Policies
& Procedures prior to ordering
No personal checks are accepted. We
will accept company checks, money orders and bank checks.
If you are ordering a share program, you can use two money orders
or split the charge on two credit cards.
Note: If you have already ordered "secure online",
this form is not needed.
Follow the instructions on the form and mail or fax to the address
listed below.
First Name:
|
__________________________ |
MI: |
__________________________ |
| Last Name: |
__________________________ |
Company/Organization: |
__________________________ |
Name as you would like it to appear on your certificate(s),
if you are ordering a certification program: |
_____________________________________________________ |
| Mailing Address: |
__________________________ |
City |
__________________________ |
| State/Province: |
__________________________ |
Zip/postal code: |
__________________________ |
| Country: |
__________________________ |
|
|
| Daytime telephone: |
(______) ____________________ |
Fax number, if available: |
(______) ____________________ |
| E-mail Address: |
__________________________@____________________________________________________ |
| How did you find us on the Internet?
(Yahoo, Exite, Info Seek, Web Crawler, etc.) |
| What was your search word(s)? |
__________________________ |
|
|
| Credit card, Debit
Card, Bank Check, Money Order, U.S. funds only |
| Account Number: |
__________________________ |
|
|
| Expiration Date: |
______/____________ |
|
|
| CVC Code*: |
___________ |
|
|
| Name on Card: |
__________________________ |
|
|
| Signature |
____________________________________________________ |
*Visa and Mastercard
In the signature box on the back of your Visa you should see
a 16-digit credit card number followed by a special 3 digit
code.
This 3 digit code is your CVC.
American Express
On the front of your card next to your main credit card number
look for a 4 digit code. This 4 digit number is the Card Security
Code.
First Name:
|
__________________________ |
MI: |
__________________________ |
| Last Name: |
__________________________ |
Company/Organization: |
__________________________ |
Name as you would like it to appear on your certificate(s),
if you are ordering a certification program: |
_____________________________________________________ |
| Mailing Address: |
__________________________ |
City |
__________________________ |
| State/Province: |
__________________________ |
Zip/postal code: |
__________________________ |
| Country: |
__________________________ |
|
|
| Daytime telephone: |
(______) ____________________ |
Fax number, if available: |
(______) ____________________ |
| E-mail Address: |
__________________________@____________________________________________________ |
| How did you find us on the Internet?
(Yahoo, Exite, Info Seek, Web Crawler, etc.) |
| What was your search word(s)? |
__________________________ |
|
|
| Credit card, Debit
Card, Bank Check, Money Order, U.S. funds only |
| Account Number: |
__________________________ |
|
|
| Expiration Date: |
______/____________ |
|
|
| CVC Code*: |
___________ |
|
|
| Name on Card: |
__________________________ |
|
|
| Signature |
____________________________________________________ |
|
For fast processing,
mail to:
NESTA AquaLogix Instructor Program
30245 Tomas
Rancho Santa Margarita, CA 92688 USA
Make business check or money order payable to:
|
For the fastest service,
pay by credit card and fax your application to:
(949) 589-8216
If you have any further questions, please call toll FREE
1-877-348-6692
NESTA - National Exercise & Sports Trainers Association. |
- Complete NESTA Aqualogix Instructor
Program on CD ___ $49
- Complete NESTA Aqualogix Instructor
Program on CD (two people) ___ $79
| Shipping Type |
Shipping Rates |
| U.S. FREE Shipping (within
the Continental U.S.) |
$0.00 |
| Military Addresses |
$0.00 |
| U.S. Hawaii, Alaska, Puerto
Rico |
$20.00 |
| U.S. 2-3 Day Air |
$20.00 |
| Canada Standard |
$30.00 |
| International Standard |
$50.00 (Estimated shipping
fee. Additional shipping fees may apply.) |
|
