Aquatic & Fitness Professional Association - International Home Study Registration form:
PLEASE PRINT
Name____________________________________________________
Address__________________________________________________
City _______________________________State______Zip_________
Phone (h)( )_________________________________________
Phone (w)( )_________________________________________
Name (s) of Homestudies or Price
___________________________________ _________
___________________________________ _________
___________________________________ _________
___________________________________ _________
Members include discount coupon(s) or copy (-)________
of MEMBERSHIP card. (Homestudies only)
Total _________
Make Check or Money order
Payable to A-PAI
1601 Great Western Dr. M3
Longmont, CO 80501
Credit Card # _________________________________________Expiration Date__________________
Name as it appears on Card__________________________ Zip Code of Billing Statement____________
Signature ______________________________________________Circle One: MC Visa AmExp Discover