Instructor Application

First Name

Last Name

Phone/Mobile

Address

Address Line 1

Address Line 2

City

State

Zip Code

Date of Birth

Preferred Pronoun

He/Him

She/Her

Them/They

Prefer not to Disclose

Are you a Veteran?

Yes

Are you a person with a disability?

Select type of instructor certification you are applying for.

What is your professional experience? Please tell us about your current and past professional experience that may relate to becoming a certified instructor.

Please provide a list of degrees or certifications you have.

Please upload your resume.

Choose File

Have you ever been convicted of a felony or a had a domestic violence charge?

Yes

If yes, please explain.

References

Please list two references we can contact on your behalf.

First Name

Last Name

First Name

Last Name

Phone/Mobile

Relationship

Do you have experience working with people with disabilities? If so please explain.

Do you have any martial arts experience? If so please explain.

Is there anything else you would like to share about yourself?

Please give us 2-3 days and times over the next 7 business days that work best for you to interview with us.

I have read and consent to the STRIVE4YOU Background Policy. I acknowledge that my $75.00 application fee is nonrefundable and will be applied toward the full cost of my $600.00 initial Instructor Certification Fee if I am accepted into the training program. Furthermore, I acknowledge that by submitting this application and any associated fee(s), does not automatically enroll me into the Instructor Certification Program and is only a step in the acceptance process.

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Application Fee

Price: $75.00

Payment Method

Pay with Card (Stripe)

Pay with PayPal