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Specialty Certification Renewal

Specialty Certification Renewal

Specialty Certification Renewal Application

Today's Date
Date Format: MM slash DD slash YYYY
Name*
First Last
Customer #*
Certification Expiration Date*
Date Format: MM slash DD slash YYYY
Address*
Street Address Address Line 2 City State ZIP Code
Email*
Phone*
Select Your Certification*
- Advanced Kettlebell
- Barre
- Indoor Cycling
- Kettlebell
- Pilates Mat
- Pilates Reformer
- Sr. Fitness
- Yoga Foundations
- Advanced Yoga
- Becoming a Yoga Professional
- Fitness Yoga
- Intermediate Yoga
- Kids Yoga
- Prenatal Yoga
- Restorative Yoga
- Sculpt Yoga
- Senior Yoga
- Yoga for Special Populations
- Yoga Strong
- Youth Fitness

CECs Completed*

Course #	Completion Date	# of CECs Awarded	Provider (NETA, ACE, NASM, or AFAA)

You must include the relevant info in the boxes above for EACH course you are submitting with the application. Click on the plus symbol to add additional lines as needed. You must attach an appropriate Certificate of Completion for each course specifically indicating the CECs (NETA, ACE, AFAA, or NASM) awarded.

Continuing Education Credits (CECs)*
Drop files here or
Accepted file types: jpg, gif, png, pdf.
You can click on the red X to delete a successfully uploaded file.

Include CECs totaling a minimum of ten (10) CECs. (*6 CEC's must be from NETA workshops or home study courses)

Allowed File Types: jpg, gif, png, pdf
Safety Certification*
New and renewing Personal Trainer certificants must hold current CPR and automated external defibrillator (AED) certification from a recognized provider (e.g. ARC, AHA, ASHI, NSC) including a hands-on practical skills assessment; and new and renewing Group Exercise Instructor certificants must hold current CPR certification from a recognized provider (e.g. ARC, AHA, ASHI, NSC) including a hands-on practical skills assessment.
- Yes, I certify that I have a current safety certification that meets the requirements above.
CPR Expiration Date*
Date Format: MM slash DD slash YYYY
Adult CPR/AED Certification Card or Certificate*
Drop files here or
Accepted file types: jpg, gif, png, pdf.
Please attached the official course completion card (front & back) or e-certificate. NETA will only accept CPR/AED certifications that include hands-on skills evaluation.

Allowed File Types: jpg, gif, png, pdf
Renewal Date Range*
- Prior to Expiration
- 1-90 Days Past Expiration
- 91-180 Days Past Expiration
If your 180-day reinstatement grace period lapses then you must retake and pass the certification test to once again earn a NETA Specialty Certification
Product Name
Renewal Total
$0.00
Comments
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Category: Renewals

Specialty Certification Renewal

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