Massage School Application Form
Name:
Date:
Address:
(H)
Phone:
Cell Phone:
(W) Phone:
Email
address:
Date of Birth:
Gender: Male Female Class preferred:
Please answer the following questions as completely as possible on a separate sheet of paper if needed. Return this 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 work.
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: info@wellnessmassagevt.com
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