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Would you like to receive our quarterly email newsletter for up-to-date info about new events and special discounts? |
Yes
No
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Have you taken one or more of the STOTT PILATES rehabilitation courses listed on this application(below) at Pacific NW Pilates before?
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| Note: Workshops and general certification courses are not considered part of the rehabilitation program. |
No, I am a new rehabilitation certification course student at Pacific NW Pilates
Yes, I am a returning rehabilitation certification course student at Pacific NW Pilates
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How did you find out about Pacific NW Pilates?
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- New applicants to Pacific NW Pilates: You must answer ALL questions in the application below. If you have never taken a STOTT PILATES certification course anywhere, you must submit a $25 processing fee with your application before we will begin processing it. If you have already completed at least one official STOTT PILATES course at another location, you do not need to include a letter of reference or a $25 application fee.
- Returning students to Pacific NW Pilates: You must submit an application that provides your current contact information only. You do not need to pay the $25 application fee.
- All applicants: You must provide official documentation of your qualifications as a health professional. (see below) Space will ONLY be reserved in a course upon receipt of your tuition deposit (following acceptance to the program if you are a new student). All Rehab courses require a tuition deposit of $250. Starting in 2010, there will also be a $100 deposit towards your exam for each of the first three modules of the Rehab Certification Program.
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Please read all the prerequisites and descriptions for these courses available here.
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RMR1 – Rehabilitation Course: Lumbar & Shoulder Girdle Stabilization on Mat & Reformer (24 hours)
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RMR2 – Rehabilitation Course: Peripheral Joint Stabilization on Mat & Reformer (24 hours)
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RCCB1– Rehabilitation Course: Lumbar & Shoulder Girdle Stabilization on CC&B (24 hours)
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RCCB2 – Rehabilitation Course: Peripheral Joint Stabilization on CC&B (18 hours)
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Please provide the dates and locations of the course(s) you are applying for:
See our schedule of rehab courses for details.
If you have already taken STOTT PILATES courses at a studio other than Pacific NW Pilates, please provide the name, email address and location of the studio(s). In addition, please indicate whether or not you have you completed your exams for these courses.
If you have already taken STOTT PILATES courses at Pacific NW Pilates, please list which courses you have completed.
Are you registering for one or more rehab courses to fulfill continuing education credits?
Yes
No
Do you require assistance locating accommodations (hotel/motel) in Washington or Oregon?
Yes
No
If you are a RETURNING rehabilitation course student at Pacific NW Pilates, you are done with this form. Skip to the bottom, read our application policies and click SUBMIT.
If you are a NEW rehabilitation course student at Pacific NW Pilates, you must fill out the remainder of this form. |
Please list degrees or diplomas related to health care.
List specific certifications related to health or fitness (ACE, AFAA, etc.).
Please provide some background information about your experience as a health care professional. Do you currently work in your field?
Describe your experience in dance, fitness or other body work, if applicable.
Provide information about your experience with the works of Joseph Pilates (if any).
Do you think you may need to take general STOTT PILATES classes (i.e., fitness classes available to the general public, not teacher training) to gain more physical experience in preparation for rehabilitation courses?
Please mail copies of your official documents verifying your licensing and qualifications. These documents can be mailed separately or brought to the studio during your interview. Please list the documents you are mailing below:
Do you have any injuries, conditions, pregnancy or postural issues (current or recent), that may affect you during the course?
How did you hear about STOTT PILATES education?
Are you interested in incorporating STOTT PILATES into your practice or are you interested in becoming a full-time STOTT PILATES instructor?
I will CALL Pacific NW Pilates with my credit card info after sending this online form.
I will MAIL a check for payment after sending this online form.
We will not process your application until your application fee has been received.
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You will not be registered for a course until we've received your tuition deposit and your exam deposit.
You will not be admitted to a course until your full tuition payment has been received.
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Pacific NW Pilates
5201 SW Westgate Dr.
Suite 114
Portland, OR 97221
503-292-4409-Phone
503-546-1249--Fax
Website: www.pacificnwpilates.com
Email: info@pacificnwpilates.com
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- Application fees for new students are non-refundable.
- A tuition deposit must be paid to reserve your spot in a course. For Rehab courses, a tuition deposit of $250 is required and a $100 exam deposit.
- Tuition must be paid, in full, two weeks (14 days) prior to the course start date to receive the Early Bird 10% discount. The 10% discount is deducted from tuition that remains after the initial deposit is paid.
- Students must withdraw or make changes to their course schedule 14 days prior to a course start date in order to receive a full refund. Late cancellations, schedule changes and/or absence from a course will result in forfeiture of the tuition deposit or require make-up time at an additional fee. The remainder of the course tuition and materials fees are non-refundable but may be applied to another course or workshop at Pacific NW Pilates within a 12-month period.
- Pacific NW Pilates reserves the right to cancel a course or workshop up to one week (7 days) before the start date and may do so if enrollment is insufficient. We highly recommend that students traveling to attend a course or workshop discuss or confirm scheduling with PNWP staff before making travel arrangements.
- In the event of a course cancellation, all paid tuition (excluding the application fee) will be refunded or may be applied to a future course or workshop at Pacific NW Pilates.
- Students will not be admitted to class if payment has not been received.
- Tax for retail items and course supplies will be applied for courses held in states other than Oregon.
Submitting this form indicates that you have read and agree to the application policies above and understand that you must pay a $25 non-refundable application fee to process your application if you are a new student.
Thank You!
If you do not hear from us within five business days of sending this online form, please contact us by phone or email to make sure that we received your information.
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