FAE Students Registration Form ๐๐ฅ๐๐๐ฌ๐ ๐๐จ๐ฆ๐ฉ๐ฅ๐๐ญ๐ ๐ญ๐ก๐ข๐ฌ ๐๐จ๐ซ๐ฆ ๐ญ๐จ ๐๐ง๐ซ๐จ๐ฅ ๐๐ญ ๐ ๐ข๐ญ๐ง๐๐ฌ๐ฌ ๐๐๐๐๐๐ฆ๐ฒ ๐๐ฎ๐ซ๐จ๐ฉ๐๐๐จ๐ฎ๐ซ๐ฌ๐/๐๐ฏ๐๐ง๐ญ ๐๐๐ฆ๐ MQF Level 3 Award In Fitness Nutrition Coaching MQF Level 3 Award in Group Fitness Instructing MQF Level 3 Award in Fitness Instructing MQF Level 4 Award in Supporting Pre and Postnatal Clients with Exercise and Nutrition MQF Level 4 Diploma In Exercise Referral MQF Level 4 Award in Personal Training MQF Level 4 Diploma in Massage Therapy for Sports MQF Level 5 Certificate In Physical Activity and Weight Management for Obese and Diabetic Clients ๐๐จ๐ฎ๐ซ๐ฌ๐/๐๐ฏ๐๐ง๐ญ ๐๐๐ฆ๐ Other๐ ๐ข๐ซ๐ฌ๐ญ ๐๐๐ฆ๐ โ- ๐๐ก๐ข๐ฌ ๐ฐ๐ข๐ฅ๐ฅ ๐๐ ๐ญ๐ก๐ ๐ง๐๐ฆ๐ ๐๐ข๐ฌ๐ฉ๐ฅ๐๐ฒ๐๐ ๐จ๐ง ๐ฒ๐จ๐ฎ๐ซ ๐๐๐ซ๐ญ๐ข๐๐ข๐๐๐ญ๐(๐ฌ)*๐๐๐ฌ๐ญ ๐๐๐ฆ๐ - ๐๐ก๐ข๐ฌ ๐ฐ๐ข๐ฅ๐ฅ ๐๐ ๐ญ๐ก๐ ๐ง๐๐ฆ๐ ๐๐ข๐ฌ๐ฉ๐ฅ๐๐ฒ๐๐ ๐จ๐ง ๐ฒ๐จ๐ฎ๐ซ ๐๐๐ซ๐ญ๐ข๐๐ข๐๐๐ญ๐(๐ฌ)*๐๐๐ง๐๐๐ซ:* Female Male Prefer not to say Other GenderOtherAddress* Street Address City ZIP / Postal Code Afghanistanร land IslandsAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCรดte d'IvoireCroatiaCubaCuraรงaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Swaziland)EthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRรฉunionRomaniaRussiaRwandaSaint BarthรฉlemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth GeorgiaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan Mayen IslandsSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUS Minor Outlying IslandsUzbekistanVanuatuVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabwe Country ๐๐๐ญ๐ ๐จ๐ ๐๐ข๐ซ๐ญ๐ก*Month123456789101112Day12345678910111213141516171819202122232425262728293031Year2025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920๐๐๐ฅ๐๐ฉ๐ก๐จ๐ง๐ ๐๐ฎ๐ฆ๐๐๐ซ*๐๐ฆ๐๐ข๐ฅ ๐๐๐๐ซ๐๐ฌ๐ฌ* ๐๐๐ฌ๐ฌ๐ฉ๐จ๐ซ๐ญ ๐๐ ๐๐ซ๐ข๐ฏ๐ข๐ง๐ ๐๐ข๐๐๐ง๐ฌ๐ ๐๐ฎ๐ฆ๐๐๐ซ*๐๐ฆ๐๐ซ๐ ๐๐ง๐๐ฒ ๐๐จ๐ง๐ญ๐๐๐ญ ๐๐๐ฆ๐/๐๐ฎ๐ฆ๐๐๐ซ/๐๐๐ฅ๐๐ญ๐ข๐จ๐ง๐ฌ๐ก๐ข๐ฉ*๐ ๐ข๐ญ๐ง๐๐ฌ๐ฌ ๐๐๐๐๐๐ฆ๐ฒ ๐๐ฎ๐ซ๐จ๐ฉ๐ ๐ฐ๐ข๐ฌ๐ก ๐ญ๐จ ๐ฌ๐ฎ๐ฉ๐ฉ๐จ๐ซ๐ญ ๐ฒ๐จ๐ฎ ๐ข๐ง ๐ฒ๐จ๐ฎ๐ซ ๐ฅ๐๐๐ซ๐ง๐ข๐ง๐ ๐๐ง๐ ๐ซ๐๐๐จ๐ ๐ง๐ข๐ฌ๐๐ฌ ๐ญ๐ก๐๐ญ ๐ฌ๐จ๐ฆ๐ ๐ฌ๐ญ๐ฎ๐๐๐ง๐ญ๐ฌ ๐ฆ๐๐ฒ ๐ก๐๐ฏ๐ ๐ ๐๐ข๐ฌ๐๐๐ข๐ฅ๐ข๐ญ๐ฒ ๐จ๐ซ ๐ฅ๐๐๐ซ๐ง๐ข๐ง๐ ๐๐ข๐๐๐ข๐๐ฎ๐ฅ๐ญ๐ฒ. ๐๐ก๐ข๐ฌ ๐ข๐ง๐๐จ๐ซ๐ฆ๐๐ญ๐ข๐จ๐ง ๐ข๐ฌ ๐๐จ๐ฆ๐ฉ๐ฅ๐๐ญ๐๐ฅ๐ฒ ๐๐จ๐ง๐๐ข๐๐๐ง๐ญ๐ข๐๐ฅ. ๐๐ฅ๐๐๐ฌ๐ ๐ฌ๐๐ฅ๐๐๐ญ ๐๐ฌ ๐ง๐๐๐๐ฌ๐ฌ๐๐ซ๐ฒ Visual Impairment Hearing Impairment Dyslexia Disability Affecting Mobility Other Physical Disabilities None Other ๐ ๐ข๐ญ๐ง๐๐ฌ๐ฌ ๐๐๐๐๐๐ฆ๐ฒ ๐๐ฎ๐ซ๐จ๐ฉ๐ ๐ฐ๐ข๐ฌ๐ก ๐ญ๐จ ๐ฌ๐ฎ๐ฉ๐ฉ๐จ๐ซ๐ญ Other๐๐ ๐๐ญ๐ก๐๐ซ ๐ฉ๐ฅ๐๐๐ฌ๐ ๐๐ฅ๐๐๐จ๐ซ๐๐ญ๐*๐๐จ๐ฐ ๐๐ข๐ ๐ฒ๐จ๐ฎ ๐ก๐๐๐ซ ๐๐๐จ๐ฎ๐ญ ๐ ๐๐?*๐-๐๐ก๐ข๐ซ๐ญ ๐๐ข๐ณ๐* XS S M L XL Other ๐-๐๐ก๐ข๐ซ๐ญ ๐๐ข๐ณ๐ other๐๐ ๐๐ฉ๐ฉ๐ฅ๐ข๐๐๐๐ฅ๐, ๐๐ฅ๐๐๐ฌ๐ ๐ฎ๐ฉ๐ฅ๐จ๐๐ ๐๐ง๐ฒ ๐๐ซ๐-๐๐๐ช๐ฎ๐ข๐ฌ๐ข๐ญ๐ ๐๐๐ซ๐ญ๐ข๐๐ข๐๐๐ญ๐๐ฌ ๐๐จ๐ซ ๐๐จ๐ฎ๐ซ ๐๐จ๐ฎ๐ซ๐ฌ๐ Drop files here or File๐/๐ฐ๐ ๐๐๐ซ๐ญ๐ข๐๐ฒ ๐ญ๐ก๐๐ญ ๐ญ๐ก๐ ๐๐๐จ๐ฏ๐ ๐ข๐ง๐๐จ๐ซ๐ฆ๐๐ญ๐ข๐จ๐ง ๐ฉ๐ซ๐จ๐ฏ๐ข๐๐๐ ๐๐ฒ ๐ฆ๐/๐ฎ๐ฌ ๐ข๐ฌ ๐๐จ๐ซ๐ซ๐๐๐ญ*YesNo๐ ๐ฎ๐ง๐๐๐ซ๐ญ๐๐ค๐ ๐ญ๐จ ๐ฌ๐ฎ๐๐ฆ๐ข๐ญ ๐๐ฅ๐ฅ ๐ญ๐ก๐ ๐๐จ๐๐ฎ๐ฆ๐๐ง๐ญ๐ฌ ๐ข๐ง ๐จ๐ซ๐ข๐ ๐ข๐ง๐๐ฅ ๐๐จ๐ซ ๐ฏ๐๐ซ๐ข๐๐ข๐๐๐ญ๐ข๐จ๐ง*YesNo