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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 photocopies of the Certificate of Completion for all CECs earned with this Renewal Application.

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 include front and back. 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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