Averill's On- Line Application
Please read carefully and answer to the best of your ability
Membership at Averill’s Martial Arts Academy is based on an application process, and is not automatic. Due to our diverse program offerings, we ask that you tell us a little bit about your area of interest in the martial arts, so that we may serve you better.
The following questionnaire is the first step.
If you are under 18 years old please have a parent fill out the application.
By filling out the application you are asking us to contact you (by phone) about our programs.
About information collected -All Information collected is to help us help you reach and determine your goals!
All information is held in confidence; we do not sell Email - Address or Phone information
If you do not fill out the application fully and misrepresent any information we will not respond to your request and your application will be denied.
Name - Address
First name
Last name
Address
City
State
Zip
Email
Contact Information
Phone
IMPORTANT - WE RESPOND TO ALL INQUIRIES BY PHONE ONLY!!!
Interests
Personal Goals
Please give us details of what your personal goals are for studying martial arts.
Please give an idea of your current fitness level.
Martial Arts Experience and Background
Do you have any prior experience?
Any information you provide helps us to place you correctly; even if you did karate when you were six and now your 25 - you know more than a complete beginner and we would place you differently. Even if you may not think it's important list it - IT REALLY HELPS!
If you answered "YES" to the question above please give us a detailed history of your training. If you answered "NO" please answer with N/A.
Age
Are you currently studying martial arts?
If you answered no for the above question please respond with N/A.
Where are you studying?
What are you studying?
Do you instruct;? Please provide a short explanation.
Your almost done; please read the following and Thank you for taking the time to fill out our
on-line application. We look forward to speaking with you.
We appreciate your patience!
ONCE WE RECEIVE YOUR APPLICATION;
Please Note: Upon receiving your application we will do our best to contact you within a couple of days by phone to set up an Introductory class, but during busy times it may take us longer to respond.
If we don't hear back from you within 5 days of our attempting to contact you, your application will be discarded and you will need to reapply.
We do not give free classes! There is a $25.00 fee for all Introductory classes, which must be prepaid at time of scheduling..
Introductory Class fees are NON-REFUNDABLE.
Should you need to cancel for any reason, we will do our best to reschedule your appointment; however, rescheduling is subject to class availability.
You must hit submit in order to send application. Hit re-set to re-start application process.
How did you hear about us?
Please let us know how found us, did you see our sign, were you referred by a friend (if so tell us who), did you search us out on the web (tell us what search engine you used Ex. Goggle), did you find us in the phone book (if so which one) or did you hear about us some other way?
