Other Exam Voucher Registration After completing this form, an email will be sent to your email address that will serve as your voucher for taking the test. Please be sure to print out the test voucher email and bring it with you to the testing location, along with a government issued ID.Certification*Select Certification TypeGroup ExerciseOlder Adult FitnessYouth FitnessExam LocationIndicate the scheduled location where you plan to take the exam? Enter the State, City and Date below. (See link below for scheduled location options.)Refer to the W.I.T.S. other exam location and date schedule and then select the appropriate location and date in the drop down menu below.Exam Location & Date*Select a Location & DateAL Montgomery 9/26/2020CA San Diego 8/15/2020 & 8/16/2020CT Manchester 10/27/2020 & 10/29/2020DE Wilmington 10/31/2020DE Wilmington 11/21/2020IL Des Plaines 11/7/2020IL Joliet 8/20/2020 & 8/22/2020MA Danvers 11/7/2020MD Salisbury 11/5/2020 & 11/7/2020MI Clinton Township 11/17/2020 & 11/19/2020MI Clinton Township 12/5/2020MO Platte City 11/14/2020NJ West Windsor 11/8/2020NY New York 12/5/2020NY Staten Island 12/6/2020NY Valhalla 12/5/2020OH Middleburg Heights 10/24/2020PA Philadelphia - Main 12/5/2020TX Arlington 11/14/2020TX Canyon 10/19/2020 & 10/21/2020TX Canyon 10/20/2020 & 10/22/2020TX El Paso 12/5/2020TX McAllen 8/22/2020VA Hampton 11/7/2020VA Virginia Beach 12/3/2020WA Everett 12/5/2020WI Green Bay 11/7/2020WI Waukesha 12/5/2020Exam TypeCHECK THE BEST BOX THAT APPLIES. Incomplete Exam (past student in a preparatory college class) Gold Exam (exclusive online preparatory student ready to test) Current Student (recently completed an optional college preparatory course & is ready to test)Code of Ethics*I have read and agree to adhere to the W.I.T.S. code of ethics. Yes, I agree.Test Confidentiality*I agree to keep any and all test information confidential about the certification exam. I will not disclose any information about the exam or cheat in any way during the exam. Yes, I agree.Test RequirementsAge Requirement* I am at least 18 years of ageCPR/AED Certification*After submitting this form you are required to email proof of your CPR/AED certification. (Live required. Online version not accepted.) It is preferred you submit a copy of your CPR/AED prior to your scheduled testing date to avoid any delays in the issuance of the Certification. If you are unable to obtain/ provide a copy prior the testing date you will still be eligible to test, but will be required to send proof within 60 days of the original testing date in order to have a Certification issued. Failure to supply a valid CPR/AED within that time from will result in a non-issuance of your certification. You will receive a confirmation email after submitting this form. Reply to the confirmation email and attach your proof of CPR/AED certification. Accepted file formats: pdf, zip, jpg, gif, png, docx, doc, xlsx, xls The certification council requires that the W.I.T.S. office must receive the proof of the CPR/AED. Your registration is not complete until you have emailed us proof of your CPR/AED certification. I will send proof of CPR/AED Certification (Live required. Online version not accepted.) I am taking the CPR/AED course soon. I will send the certification card or confirmation letter as proof within 60 days of the original testing date in order to have a certification issued.High School Diploma/GED* I have earned my High School Diploma or GED equivalentHigh School Diploma / GED Details*For Diploma: Enter the name, city and state of high school, and date of graduation. (ex. Central High School, Virginia Beach, VA, 2014) For GED: Enter GED, state and date you earned your GED. (ex. GED VA 2014)English Comprehension* I have English comprehension for the written and practical examsCOVID-19 Notice*We care about our student trainers, teachers and testers. Therefore, we are requiring masks to enter the gym or college location at the assigned time/s. I understand that due to the COVID-19 pandemic that there is a risk. I agree to wear a mask at all times and that I will be asked to leave the facility if I do not have one or wear it on site at all times.ADA accommodations needed?*YesNoALERT: Send all ADA official document forms to Devon Lewis at email@example.com at least 30 days in advance of the exam or your testing may be delayed, as adequate time is required to verify and arrange your special accommodations with the hosting college. Delays in receiving the ADA forms for verification can delay your test being delivered on time.Student InformationName* First Last Email* Phone*Country*United StatesOther (Canada, Jamaica, etc.)Address* Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code International Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanÅland IslandsAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCôte d'IvoireCroatiaCubaCuraçaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Swaziland)EthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRéunionRomaniaRussiaRwandaSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth GeorgiaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan Mayen IslandsSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUS Minor Outlying IslandsUzbekistanVanuatuVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabwe Country Date of Birth* Date Format: MM slash DD slash YYYY GenderSelect GenderMaleFemalePrefer not to answerPhoneThis field is for validation purposes and should be left unchanged.