EmailMe Form - Personal Trainer Application

Name *

First Last

The information you are providing on this form will not be sold or shared with any other company. However, if your application is approved, you are giving consent to advertise this material on PTHit.com and JessiHit.com. Further, you acknowledge that the instructions you are providing are truthful and of fact. If there is any specific data on this form that you would prefer not to display on your listing, please complete the field at the bottom of this form labeled, "Exclude Certain Information on my Listing". The required fields however are still necessary for the company to communicate with you internally.

Email *

Company

If you are owner or partner in a registered FBN, INC or LLC, please list here, otherwise please leave blank.

Phone *

### - ### - ####

Address

Street Address Address Line 2 City State / Province / Region Postal / Zip Code

Years of Experience *

Certifications

Certificate #1
Certificate #2
Certificate #3

Please list all of your Certifications here. If you have more certificates that do not fit here, you may include them under "Additional Information" near the bottom of this page.

Upload Photo

Please choose one photo of yourself and upload here. If your application is approved, this photo will be displayed next to your name on PTHit.com. You will have an option later to revise your photo. You can also email a photo to trainer.pthit@gmail.com.

Website

This should be your personal website, if any, or website you have authorization to advertise.

Social Media

You may include up to two Social Media links.

Home Gym

This could be the gym you own or one you train out of.

Home City of Choice ($225.00) *

This is the city you would like to represent. If approved, you will be the only Personal Trainer representing this specific city. Additionally, you will have an opportunity to take part of a Jessi J HIIT Camp in this city. Any Client you sign up will be 100% yours, therefore all revenues belong to you.

Additional Cities

City #2 ($200.00)
City #3 ($175.00)
City #4 ($150.00)

If you would like to be the face of more than one City, please list those cities here. The prices listed cover one full year of advertising.

Additional Information

You should include all Personal Training Certificates here and any additional information about you for final consideration.

Exclude Certain Information on my Listing

Once your application is approved, you will be forwarded a formal advertising agreement. You will have the opportunity to edit your advertised information at that time. If ever you have any questions in regards to this contract, please contact Jessi at 805.625.0845 or trainer.pthit@gmail.com.