Licensing Information

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Thank you for your interest in becoming a Body Sculpting Fitness Program Licensee. We are looking for committed, creative and enthusiastic fitness professionals to help expand our award-winning exercise programs thoughout the United States. Please review our Frequently Asked Questions section that provides thorough information about purchasing our fitness program licenses. After reviewing this information, if you would like to further explore how to become a licensee, please complete the online License Application. Include any additional questions or comments on the bottom of the form. Our staff will review this form and will contact you to schedule a telephone interview.

Personal Information
First Name:
Last Name:
Address:
City:
State:
Zip:
Phone:
Fax:
Email:
Company/Facility:
Years in Business:

License Information

License will be purchased for:

Individual City Wellness Center Health Club

Recreation Center Senior Center University/College

Retirement Center Hospital Country Club/Driving Range

Dance Studio Church/Synagogue Other

Program(s) you are interested in purchasing:

Flex Express® (Body Sculpting)	Phenomenal Abdomimals®
Golf-Fit®	Back-Fit with Pilates®
Teen-Fit®	Just Legs®
Stretch This®

Facility Where Classes will be held:

At how many locations are you planning to teach class?

In which cities, townships or counties do you wish to offer class?

When are you planning to begin class?

Will you be the instructor?
Yes No

General Information

How did you hear about Body Sculpting?

Have you ever taken Body Sculpting before?
Yes No

If yes, where and when?

Have you ever owned your own business or franchise?
Yes No

Please share any training or background experience relevant to becoming a Body Sculpting licensee?

Training, Certifications, or Licenses (PT, OT, Instructor, etc.):

List any hobbies, community activities, special interests or other relevant information:

Background Information

Of which country are you a citizen?

Have you ever been convicted of anything other than a minor traffic violation?
Yes No

Has any judgement ever been entered against you, your compnay or your employer where you were one of the litigants?
Yes No

Are you involved in a pending litigation?
Yes No

Have you or your spouse ever declared personal bankruptcy?
Yes No

If you answered yes to any of the above questions, please explain:

References

Please list three references, excluding employers and relatives:

Reference #1
Name:	Address:	Phone:	Years Known:

Reference #2
Name:	Address:	Phone:	Years Known:

Reference #3
Name:	Address:	Phone:	Years Known:

Please complete the following statement, I am confident I can be a successful Body Sculpting Program Licensee because:

Comments or Questions:

Acknowledgement

By submitting this application, I hereby acknowledge the information in the application to be true and correct. I understand that this application is in no way binding to the applicant or Exterior Designs, Inc., and that this information will be used to assess the suitability and qualifications of the applicant. I understand that any information I may receive from Exterior Designs, Inc. is confidential and may not be used or shared without the consent of Exterior Designs, Inc.

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440-729-3463