Personal Trainer Request Form

THIS IS ONLY A REQUEST. One of the trainers will get back to you to set up an appointment. You must be a current CSB student to be eligible to work with a trainer. There is no cost to you to sign up for a trainer.

First Name

Last Name

Phone Number

Email Address

Have you ever met with a certified personal trainer here at CSB?

	Yes
	No

If you answered yes, please tell us which trainer you met with.

I would prefer to work with a Certified Personal Trainer that is:

	Female
	Male
	Doesn't matter

Please list specific availablity (days and times) that you would be available to meet with a trainer.

Additional Notes

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