Subscription Application Form


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Secure Subscription Form

We respect your privacy. The personal information requested below is for use in processing your credit card, which is done with secure encryption. We never reveal, share, or sell member information. Find complete details of our Privacy Statement. If you prefer, you may join by sending a Cheque or using PayPal.

Customer Information

* = Required - Must match credit card billing address!

First Name [ required ]
Last Name [ required ]
Company
Address Line 1[ required ]
Address Line 2
City [ required ]
State [ US & Canada ]
State/Province [ All other Countries ]
Postal Code/Zip [ required ]
Country [ required ]
Your E-mail Address [ required ]
Phone or Fax Number [ required ]

Subscription Options

Subscription Plan: Automatic Renewal - You will be charged automatically, according to your price plan.	Fitness Membership You get full access to our site for ONLY £5.99 per month. 1 Month £5.99 NOTE: If you are already a member of our site and you are upgrading then select 'YES' this is a renewal. Access All Areas You get full access to EVERYTHING on our site. 1 Month £7.99

Choose LOGIN Name [ required ]

Choose PASSWORD [ required ]at least six characters long, using alphas and numbers, no spaces.

Confirm PASSWORD [ required ]

Payment Information

Payment Method [ required ]
Credit Card Number [ required ]
Credit Card Security Code [ required on (MC/Visa/AMEX) ? ]
Issue Number [ SOLO or SWITCH cards only ]
Expiration Date [ required ]	/
Name on Credit Card [ required ]
Is this a Renewal?
Do you wish to receive email alerts?
YES! I want to become a member of MyFitnessInstructor.co.uk today! <<< Please Check The Box to acknowledge that you have read and understood our terms of use.


NOTE: It can take up to a minute to process the credit card information and obtain approval. Please do NOT press the submit button multiple times - doing so could cause double billing.
For the protection and privacy of our visitors and customers, as well as the security of the server, suspicious activities on our site are monitored, tracked and reported.