FISAF SINGAPORE

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Course Application

Full Name
NRIC/Passport No.
Date Of Birth
Gender	Male Female
Address
Home Tel.
Handphone No.
Fax
Email Address
Are you a Fitness Instructor?	Yes No
	Full-Time Part-Time State Club:
	State Occupation:
Are you CPR Certified?	Yes No
Indemnity I will not hold FISAF Singapore, and/or anyone/organization representing FISAF Singapore, responsible for any personal loss, damage or injury as a result of my participation in this course.
Note: Upon submitting, your application form will be displayed to you. Please print and sign the application form and mail it together with cheque (payable to 'KINETIC CHAIN') to: KINETIC CHAIN c/o Ms Shiny (secretary) Blk 19, Teck Whye Lane #05-45 SINGAPORE 680019