Massage School Application Form
Date of Birth:
Gender: Male Female
answer the following questions as completely as possible on a separate
sheet of paper, if needed. Return the application with a $200
nonrefundable deposit to hold a spot in the class.
1. What is your reason for choosing to become a massage therapist?
2. Other than high school, explain any other education/training that you have received.
3. Have you ever received a professional massage treatment?
4. What do you currently do for work? Do you see any difficulties in completing the
class expectations as well as your employment expectations?
5. Do you have any physical problems that may prevent you from doing this kind of
Please send completed form to:
Wellness Massage Center and Institute
164 N Main St # 2
St Albans, VT 05478
Questions? Phone: (802) 527-1601 Email: firstname.lastname@example.org