2014 Focused Fitness
Summer Institutes
Sign-up Form
Welcome to the Summer Institute Sign-up Form!
For information on the Focused Fitness Summer Institutes, please see our
official Summer Institutes page
.
Personal Information
First Name:
Last Name:
Organization / School District:
Job Title:
Personal Address:
Personal City / State / Zip:
Billing Address (if different):
Billing City / State / Zip:
Work Phone:
Cell Phone:
Email
(accessible during summer)
:
Confirm Email:
Institute Selection
FAB 5 Early Learner Fitness (ELF) Institute: 7/16/14 – 7/17/14 - $330.00
Focused Fitness Best Practices Institute: 7/21/14 – 7/23/14 - $435.00
Shirt Size:
Small
Medium
Large
X Large
XX Large
Dietary Considerations:
None
Vegetarian
Vegan
Specify Other...
Other:
Source Code:
Conference Total: $
0.00
Curriculum Orders
Pricing reflects a 20% discount.
Washington state sales tax of 8.7% is included in price shown
. Materials will be available for pick-up at the Institute.
Early Learner Fitness Program - $296.00
Basic Manual (K-5) - $209.00
Intermediate Manual (6-8) - $209.00
Advanced Manual (9-12) - $209.00
Product Total: $
0.00
Payment Information
Grand Total: $
0.00
Credit Card
(Visa or MasterCard)
Check
Purchase Order
Please phone in your credit card information to 509-327-3181 ext. 136 (Bookkeeping)
Please make checks payable to Focused Fitness and mail to:
Focused Fitness
Attn: Bookkeeping
2426 S Dishman Mica,
Spokane Valley, WA 99206
Please send Purchase Order by fax to 509-927-8551, Attn: Bookkeeping
Verification Image:
Enter 6 digit code from the above image: *