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The information gathered on this page is used by the American Senior Fitness Association only to assist us in administering your course and in maintaining records on course completion. We respect your privacy and will not share your registration information with anyone else without your written consent or as required by law or legal process.

Note: The name entered here will be printed as "[First name] [Last name]" on an automatically generated CEC Validation Form for submission to your accrediting agency. This form will become available once you have completed your course. If you desire, you may include middle name or initial and/or pre- and post-nominal titles in these two fields. For example,

First name: Dr. Jane P.
Last name: Doe, EdD, CPT

You will be able to edit this information later while logged into your account under "My profile settings."

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First Set
First Set
First Set
Second Set
Second Set