Steps Steele Pilates Teacher Certification Program Application Checklist (International Students) Items to be included in your Application Packet*: Completed application checklist Completed application form Letter of introduction detailing the type of Pilates you have been studying (if any), the number of years you have been studying, and any current certifications you may have. Please also describe any dance training you have had and the number of years you have been studying. Please describe your future goals in the dance/fitness industry. Dance and Fitness resume (if any) One passport sized photograph One photo in a dance or fitness pose that highlights your technique Health Form Copy of Current Passport Financial documentation proving funding for tuition and living expenses. Please refer to International Student Guide for acceptable forms of documentation Non-refundable $250 application fee payable by bank transfer, credit card, money order, or travelers checks in U.S. dollars. Cash is not accepted. For bank transfer - JP Morgan Chase 2099 Broadway New York, NY 10023; Account # 633102962 Routing # 021000021. Please include an additional $28 for bank fees. Credit cards - American Express, MasterCard or Visa only. * - Incomplete application packets will not be accepted Acceptance Within two weeks of receiving your completed application, Steps on Broadway will notify you by email of your acceptance. Items to be sent After Acceptance: Fifty percent (50%) of the tuition is due within ten (10) days of receiving your acceptance notice. The remaining fifty percent (50%) is due ten (10) days prior to your program start date. Non-payment will result in delay or loss of position within the program. Payments plans are based upon financial need on an individual basis. All rates are subject to change. Mailing address: Steps on Broadway Professional Training Programs 2121 Broadway @ 74 th Street, Third Floor New York, NY 10023
Steps Steele Pilates Teacher Certification Program Application Form (International Students) First Name Last Name_ Email Phone Address in Home Country Street City State Postal Code Country Address in New York (if established) Street City State Zip Male Female Date of Birth / / Native Language Month Day Year Country of Birth Country of Citizenship Current Certifications (if none, write none) Passport Number Expiration Date I WOULD LIKE TO ENROLL IN (students may select both sessions): Mat Certification (October 10, 2015 December 12, 2015) Application deadline August 1, 2015 Advance Certification (January 16, 2016 March 19, 2016) Application deadline November 1, 2015 Enclose a check for the Application Fee of $250.00 made payable to Steps on Broadway Credit Card: American Express MasterCard Visa Name on Credit Card Number Expiration Date How did you hear about this program? I hereby represent that I am over eighteen (18) years of age X Print Name Date
International Student Application Guide Financial Support* To be accepted to Steps on Broadway, international students must have sufficient funding for both school tuition and living expenses for the duration of their program. All documents must be in English and currency in US dollars. Students must prove an amount greater than or equal to: Independent Study Program $7,500 for a 3 month period $13,000 for a 6 month period $26,000 for a 12 month period 2-Year Conservatory Program $26,500 for a 9 month period $32,500 for a 12 month period (students planning to stay in New York during summer break) Steps Steele Pilates Teacher Certification Program $8,700 for a 3 month period $17,400 for a 6 month period The following documents are acceptable forms of financial support: Official Bank Statement-The statement must be on bank letterhead and in the name of the applicant or sponsor. Official Bank Letter-The letter must be on bank letterhead and confirm a balance equal to or in excess of the tuition and living expenses for the expected length of studies. Official Proof of Income or Employment of Family Member-A letter, paycheck stub, or annual income tax return from a family member proving employment and ability to provide for your tuition and living expenses. Family member must prove an amount greater or equal to double the monthly tuition/living expenses of the student. Affidavit of Support If the statement, letter or proof of income is in the name of any individual other than the applicant, the sponsor must provide a letter stating that they are willing to support the applicant for the duration of their course of study. Official Award Letter-If the applicant is receiving a government or institutional scholarship, grant, or loan, please submit the award letter. The award letter must state the amount and duration of the scholarship, grant or loan and must specify if the funds are renewable on an annual basis. If the award does not cover the total cost of tuition, fees and living expenses, additional financial documentation must be enclosed. Health Insurance Students are expected to carry health insurance for the duration of their course of study. Students may provide proof of current health insurance or sign up for the group plan through Steps on Broadway. More information available upon request. *Please note these are not tuition prices. They are tuition and living expenses combined.
PROFESIONAL TRAINING PROGRAM HEALTH FORM I. STUDENT INFORMATION Name (Please Print) Phone Number Date of Birth (Month/Day/Year) Emergency Contact Relationship to Student Phone Number II. HEALTH INSURANCE INFORMATION (Please note that health insurance is required for all PTP students) Do you currently have health insurance coverage? Yes If yes: Insurance Company Dates of Coverage (Please include a copy of your health insurance card or other proof of insurance with this application) No, please send me information about Steps Group Health Plan (International Students Only) No, I plan to find coverage prior to enrollment and will provide proof of insurance at orientation. III. MEDICAL HISTORY Do you have any medical conditions that we should be made aware of? Yes No If yes, please list the medical condition(s): Is there any other information regarding your condition(s) that you would like us to know?
III. MEDICAL HISTORY (continued) Do you take any medications? Yes No If yes, please list all medications: Do you have any allergies? Yes No If yes, please list all allergies: Please list any physical and/or dance related problems you have including injuries, bone, joint or muscular disorders, etc. ACKNOWLEDGEMENT I do hereby state that, to the best of my knowledge and belief, the medical history I have provided is correct and accurate. I agree to report, in a timely manner, injuries and/or conditions that are pre-existing or have occurred while participating in the Professional Training Program (PTP). I understand my medical history is confidential under state and/or federal laws and that Steps Studio Inc. staff will not release to anyone or discuss with anyone outside of the company, unless separately authorized by me or required or permitted by law. I authorize Steps Studio Inc. to speak in their sole discretion with any Hospital Representative and/or Medical Provider about injuries, illnesses, treatment and rehabilitation that may affect my ability to participate in the PTP and/or any injury suffered during my participation in an activity associated with PTP. My signature below acknowledges that I understand and agree to the terms above. (Student Signature) (Date)