Polestar Pilates - Tell Us About Yourself Survey

1
First & Last Name* This field is required.NOTE: your information will NEVER be shared with other organisations.
First Name
Last Name
2
Email* This field is required.
example@example.com
3
Address* This field is required.
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Please Select
Please Select
United States
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Finland
France
French Polynesia
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The Gambia
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Mali
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Mauritius
Mayotte
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Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
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Norway
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Paraguay
Peru
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Poland
Portugal
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Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
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Samoa
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eSwatini
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Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
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Tokelau
Tonga
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Tristan da Cunha
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Isle of Man
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Other
Country
4
Mobile or Phone Number* This field is required.
Area or Pre-Code
Phone Number
5
Gender
Male
Female
N/A
6
Age
18 - 24
25 - 34
35 - 44
45 - 54
55 - 64
65 or more
7
Click YES if you want to stay informed about our courses and workshops through our regular emailed newsletters* This field is required.Please note you can always unsubscribe at a later stage if you wish to do so
YESNO
8
Pre-requisites to the Certification Courses* This field is required.Other than with the Polestar Gateway courses, all Polestar Teacher Training courses require you to meet certain pre-requisites, as mentioned below. Please tick ANY or ALL of the below options IF they apply to you:
Successful completion of an Anatomy and Physiology course through a recognised education body, or fitness/movement professional, or licensed or certified health care professionals (e.g. MD, PT, OT, DO, DC,RN, and Bach. Sp Sc. / Hum Movt. and Bach Applies Science).
I have had a minimum of 25 hours of personal Pilates practice – either private or group instruction
None of the above
9
Great to see you've had previous Pilates practice!Please indicate what type of Pilates experience(s) have you had - tick all that apply:
Mat
Comprehensive / Studio
Reformer
Other
10
Name the studio & location where you've had previous Pilates experience
Type the name of the studio
Type the city or town where the above studio is located
11
Tell us a bit about your backgroundI am a....
Registered Physiotherapist
Occupational & Physical Therapist
Osteopath
Health professional interested in adding Pilates to their patient work
Personal Trainer / Fitness Instructor
Pilates enthusiast or prospective student who wants to become familiar with the method before taking the professional leap
12
What are your goals with completing a Pilates Instructor Training?* This field is required.
For example: I want to start my own Pilates Studio, or I want to further myself in Pilates teaching
13
How did you find out about Polestar Pilates?
Google search
From a previous or current Polestar student
Facebook
Instagram
14
Tick any Polestar Pilates training courses that you are (potentially) interested in:
Gateway Matwork
Gateway Reformer
Reformer Series
Comprehensive Series
Mat Series
Continuing Education Workshops
15
Have you read our website with the course info including dates and cost? www.polestarpilates.co.nz
YESNO
16
Have any other questions? Let us know below what other questions you may have at this stage.
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THANK YOU VERY MUCH for taking the time to provide us with your background and interests - we will contact you within 1 to 2 days!

In the meantime, you can ALWAYS call or email us:

📞 +64 - (0)9 - 303 2211

📧 info@polestarpilates.co.nz

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