PERSONAL PROTECTION LLC
Instructor Information Form
Please type your name:
Please type your email address:
Please check your Certification information:
How long have you been Certified?
Do you currently have a web page?
If Yes, Please type your web address:
Approximately how many students do you train annually?
Do you currently have Liability Insurance?
Would you be willing to accept and train students if referred to you by PPI?
Are you willing to sign a Liability Waiver to PPI?
If yes, are you willing to name PPI as Additional Insured on your Liability Policy?
If you answered "no" to either of the last two questions, please discontinue this form and hit "Reset" to clear it before leaving this page. >>>>>>>>>
Please type your City: and State:
If you believe that this might be an opportunity to gain new students and a mutually beneficial relationship please hit the "Submit" button. You will receive an email acknowledgement within 24 hours. Thank you for your interest and if you are accepted as one of our "Referral Instructors" we look forward to referring any students that we can from your area directly to you.
"Train Well, Train Often, Train Safely"
Your phone #:
