Application for Acceptance
Name:
Address: City: State Zip
Telephone: Home:      Work:        Alternate: 
Email Address:   Date Of Birth:     Age:    Gender: 
Emergency Contact:  
High School:            Year Graduated: 
College/Vocational:         Degree/Year Achieved: 
Problems that may affect Massage Performance:
Communicable Diseases:
Current Medications:
Mental Challenges:
Learning Challenges:
Have you ever been convicted of a crime?

Why do you want to be a massage therapist?
What are your career goals?
What are your hobbies?
What are your strengths and how will they help you as a massage therapist?
Please outline your time management schedule to include school study time into your life schedule.
Please outline a financial plan that will help you meet your tuition obligations.

 



Member of


All information, photos, and graphics are
© Holistic Center for Therapeutic Massage
and their respective owners.
All Rights Reserved