Privacy Disclosure of Information Form
The Academy of Fitness is required to verify some documents you may have recently submitted with the previous training provider. In order to contact the previous training provider, we must have your written consent to disclose information and validate your documents. Please fill out and sign the form below that you agree for the Academy to contact the provider.
Full Name
*
First Name
Last Name
Mobile Number
Please enter a valid phone number.
E-mail
*
example@example.com
Select the documentation that is required to be verified:
First Aid
CPR
Certificate III
Other
I give written permission for the Academy of Fitness to contact and verify my documentations with:
*
Please enter your training providers name from the documentation required to be validated here.
Signature
*
Submit
Should be Empty: