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Equal Opportunities Monitoring

The Fitness Education Academy is committed to a policy of equal opportunities. One of our aims is to ensure that discrimination on the grounds of race, sex or disability is avoided. To ensure that this policy is fully and fairly monitored please complete the relevant details below. The information collected will form a confidential statistical record which will not be used for any purpose other than our policy on equal opportunities.
White British
White Irish
White Other
Mixed white and black Caribbean
Mixed other
Black or black British - African
Black or black British - Caribbean
Black or black British - other
Mixed white and black African
Chinese
Asian or Asian British - Indian
Asian or Asian British - Pakistani
Asian or Asian British - Bangladeshi
Asian or Asian British - other
Mixed and white Asian
Prefer not to say

Support Needs

So that we can assess your needs please indicate if you have any disabilities or other support needs. This information will be treated with confidence. Please note that answering these questions will not prejudice your application in any way.

Blind or visually impaired
Deaf or hearing impaired
Disability affecting mobility
Other physical disability
Mental health issues
Temporary disability or illness
Multiple physical disabilities
Multiple learning difficulties
Moderate learning difficulty
Severe learning difficulty
Dyslexia
Dyscalculia
Dyspraxia

Medical Questionnaire

Has your doctor ever said that you have a heart condition and that you should only do physical activity recommended by a doctor? YesNo
Do you feel pain in your chest when you do physical activity? YesNo
Do you close balance because of dizziness or do you ever lose consciousness? YesNo
Do you have a bone or joint problem that could be made worse by a change in your physical activity? YesNo
Is your doctor currently prescribing drugs (for example, water pills) for your blood pressure or heart condition? YesNo
Do you know any other reason why you should not do physical activity? YesNo

Payment

I have paid via webiste (Stripe)
Request a payment link (stripe)
Request a Debit/credit card callback
Debit/credit card payment over telephone 01968 679100
Payment made by BACS to bank account:

Sort code: 80 09 39
Account number: 10033360
Account name: The Fitness Education Academy Limited

Declaration

I have read and understood the terms and conditions. You can view our terms here.
I have read and understood the privacy policy. You can view the policy here.
I confirm that the details on this application are to the best of my Knowledge correct.

Course Application Form

Personal Details

Equal Opportunities Monitoring

Support Needs

Medical Questionnaire

Payment

Enter Discount Code

Declaration

Course Application Form

Course Application Form

Personal Details

Equal Opportunities Monitoring

Support Needs

Medical Questionnaire

Payment

Enter Discount Code

Declaration

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