ITCA
division
NESTA

NESTA Triathlon Coach Certification

ITCA Triathlon Coach Certification Order Form

 

Registration is available January 5, 2009


Please read the Policies & Procedures prior to ordering
No personal checks are accepted. We will accept company checks, money orders and bank checks.

Note: If you have already ordered "secure online," this form is not needed.
Follow the instructions on the form and mail or fax to the address listed below.

Please print clearly or type:
First Name:
__________________________ MI: __________________________
Last Name: __________________________ Company/Organization: __________________________

Name as you would like it to appear on your certificate(s), if you are ordering a certification program:

_____________________________________________________
Mailing Address: __________________________ City __________________________
State/Province: __________________________ Zip/postal code: __________________________
Country: __________________________
Daytime telephone: (______) ____________________ Fax number, if available: (______) ____________________
E-mail Address: __________________________@____________________________________________________
How did you find us on the Internet? (Yahoo, Exite, Info Seek, Web Crawler, etc.)
What was your search word(s)? __________________________
Credit card, Debit Card, Bank Check, Money Order, U.S. funds only
Account Number: __________________________
Expiration Date: ______/____________
CVC Code*: ___________
Name on Card: __________________________
Signature ____________________________________________________

*Visa and Mastercard
In the signature box on the back of your Visa you should see a 16-digit credit card number followed by a special 3 digit code.
This 3 digit code is your CVC.

American Express
On the front of your card next to your main credit card number look for a 4 digit code. This 4 digit number is the Card Security Code.

For fast processing, mail to:
NESTA Triathlon Coach CertificationOrder
30245 Tomas
Rancho Santa Margarita, CA 92688 USA

Make business check or money order payable to:
NESTA

For the fastest service, pay by credit card and fax your application to: (949) 589-8216

If you have any further questions, please call toll FREE 1-877-348-6692

NESTA - National Exercise & Sports Trainers Association