Check preference and indicate second choice of training dates.
***Application must be received ONE MONTH prior to training dates selected***

 ONLY THOSE WHO WISH TO PROVIDE LEADERSHIP 
FOR ADULTS IN EXERCISE PROGRAMS SHOULD APPLY.

        NAME____________________________________________ Daytime Phone #_______________________   

        MAILING ADDRESS________________________________ Evening Phone # _______________________

        City__________________________________________________, State_____________ ZIP____________    

         email __________________________________________________                M____   F____

       Are you attending school now?________    Degree last earned_______________________________________

       (Current students need to be in contact with our office before making application)

       Major course of study in college:______________________________ Occupation______________________

Are you now working with the older population?____ If yes, in what capacity?____________________________  
In what setting will you establish you Body Recall class?_____________________________________________

Double or single occupancy*____________ Roommate____________________________________________

Date of arrival _____________________________ Approximate time_________________________________

     Traveling by car_____   bus_____   air _____ ?

Need for shuttle service from Lexington Airport ($35.00 round trip)?__________

     Arrival time_________________________ Airlines and Flight #______________________________________

     Departure time______________________  Airlines and Flight #______________________________________

*Fees may vary for regional trainings in TX, AR & MI.  Contact headquarters for further information.  
Workshop fee for 5 nights and 5 days is based on double-occupancy unless you indicate otherwise.  (Single-occupancy carries an additional charge of $100.00 per week.)  A non-refundable deposit of  $100.00 must accompany this application.  The balance ($750.00) will be due on or before registration.  We reserve the right to cancel any training due to low enrollment.  In such a case your full deposit will be refunded.                                                                                              

MAKE CHECKS PAYABLE TO and MAIL TO:   BODY RECALL, INC.