ENROLLMENT APPLICATION

Name:*

First

Last

Middle

Address:*

Street AddressStreet Address Line 2CityState / Province / RegionPostal / Zip CodeCountry

E-mail:*

Phone:*

Area Code

Phone Number

What Schedule Is Best For You*

Daytime

Evening

Either Daytime Or Evening

Tell Us Why You Want To Become A Massage Therapist*

Highest Level Of Educational Background Completed*

Employer Name*

Employment Address:*

Street AddressStreet Address Line 2CityState / Province / RegionPostal / Zip CodeCountry

Briefly Describe Your Job Duties*

Please read these statements and acknowledge that you understand them. Licensing of Massage Therapists State Of Pennsylvania requires a criminal background check for all applicants prior to taking the State Board of Massage Therapy Licensing. Any massage therapy student who has a prior criminal conviction may experience limitations and/or denial of professional licensure or employment opportunities due to previous criminal records. We encourage potential students to investigate the details of licensure laws in the state(s) and/or municipalities where they would like to practice. I understand that I need a license to practice massage therapy in Pennsylvania. Please check rules and regulations of other states you may desire to work. Self Employment Acknowledgment In our program we educate each student on the potential to be self employed. In the Business Mastery Course success in business ownership is taught. I understand that I have the option to be self-employed in my chosen field. The information I have provided is true and correct to the best of my knowledge. I have read and understand the above disclosure statements. I wish to have my application for admission considered by European Medical School Of Massage LLC *

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ENROLLMENT APPLICATION

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