Name: .............................................................Signature.........................................................
By completing this form and submitting the payment, I agree to the terms and conditions of the Pilates Institute of Australasia Training courses and refund policies.

Address: ...............................................................................................................................

State: ............... Postcode: ...............Country: .................................................

Telephone (W): ................................(H)...................................

Fax: ...............................Mobile:..........................................

Email: ..............................................................................Current PIA Member?

Attach copies of: First Aid, Cert III + 2 Years teaching Cert IV + 12 Months Teaching

Practitioner (State physio/osteo/chiro)...............................................

Pilates Courses completed anywhere: 1....................................................................

2................................................................................................................................................................................................................

Please calculate course prices from webpage with course dates.All prices include GST.
1 If booking Floor 01 and Ball 01 at the same time REDUCE TOTAL COST BY $100.00 (Off FULL price of Ball course)
2 EARLYBIRD SPECIAL: IF BOOKING and paying for FLOOR 01 EIGHT WEEKS PRIOR TO START OF COURSE, REDUCE TOTAL BY A FURTHER $100.00.
3 To book any other course 8 weeks in advance, deduct $25.00.
4 All courses include a DVD of that course, unless unavailable. Workbooks will be sent out by email to download and bring to the course.

The Floor Level 1 Course includes "The Complete Guide to the Pilates Method" Theory e-Book and The Pilates Floor 01 DVD; (P/H of $A18.00 overseas, Free postage in Australia)
ONLY CREDIT CARD PAYMENTS or EFT CAN BE ACCEPTED FOR OVERSEAS COURSES

Cheque Money Order Bankcard Visa Master/Eurocard

Credit Card number __ __ __ __. __ __ __ __. __ __ __ __. __ __ __ __ Exp date __ __ /__ __
CVC __ __ __(last 3 digits on back of card)

Name on Card : .........................................Signature on Card : ...........................................

You can also credit the funds directly into our bank account:
Account name: Pilates Institute of Australasia
Bank: St George Bank
BSB: 112-879
Account Number: 044081261
Please state your name and Pilates "City" (where " City" is the city where you are doing the course) in the reference section when transferring the funds.

Prices and dates of courses subject to change without notice. Minimum 10 attendees required to conduct courses. No refunds 4 weeks prior to course commencement. $50 LATE PAYMENT FEE APPLIES to courses booked within 14 days of the course to cover Express Mail delivery of course materials. If the PIA cancels the course due to lack of numbers, we will provide a full refund, minus course materials already sent.
I agree to teach no more than 20 people in classes upon completion of the course. Floor 1 Course prerequisite: study of "the Complete Guide to the Pilates Method" and 20 sessions from the Floor 1 DVD.
Further DVDs/Videos and Books can also be purchased online
REFUNDS: prior to 8 weeks: $100.00 Admin fee charged; 4-8 weeks 50% refunded; less than 4 weeks - no refund.

Print this page & fax it and supporting documents to The Pilates Institute of Australasia +61 2 8920 2633

or send the application and supporting documents to:
EDUCATION DEPARTMENT
Pilates Institute of Australasia
PO Box 1099
CHATSWOOD 2057
AUSTRALIA