Student Information
Name:
E-mail Address:
Course Date:
Age:
Gender:
Male
Female
Highest Education Level:
Please select education level...
12 = High School/GED
13 = College Student < 2 years
14 = Associates Degree
15 = College Student < 4 years
16 = Bachelors Degree
17 = Masters Degree Student
18 = Masters Degree
19 = Doctoral Candidate
20 = Doctoral Degree
Specialty:
Physical Therapist (PT)
Occupational Therapist (ORT/L)
Certified Ergonomist (e.g. CPE)
Registered Nurse (RN)
Certified Athletic Trainer (ATC)
Exercise Physiologist
Certified Rehab. Counselor (CRC)
Physical Therapy Student
Occupational Therapy Student
Ergonomics Student
Nursing Student
Athletic Training Student
Exercise Science Student
Rehab Counseling Student
Other
Other (describe):
Years of Practice:
Do you have any prior FCE experience?:
Yes
If Yes, describe type or brand of most recent FCE system: