USOLMT New Member Form
USOLMT New Member Form
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Email *
What is your First and Last Name? *
Please enter your address. *
Phone Number *
Membership Type & Insurance
What Type of Membership Are You Signing up For? *
Required
Why did you decide to Join USOLMT? What are your major concerns? How can we support you the most? *
Do you plan to purchase liability insurance coverage through USOLMT's partnership with Insurance Canopy? *
Classification
Please provide clarity on your classification as a Massage Therapist.  Check All that Apply. *
Required
Please provide your Business Name / School Name / Employer, and the City or Location Name (1) *
Please provide your Business Name / School Name / Employer, and the City or Location Name (2) Type None if you are only at one location. *
Please provide your Business Name / School Name / Employer, and the City or Location Name (3)  Type None if you are only at 1 or 2 locations. *
What are your Job Titles?  Check all that Apply. *
Required
What Type of Massage do you Practice? Please check all that apply. *
Required
Please provide all links to Your Business / School / Employer's Websites: *
Licensing Information
What is your License Number?  (If a Student or Unlicensed, type None.) *
Associations & Affiliations
What Massage Associations are you a member of?  Also, please provide any other community or volunteer organizations to which you belong or serve. *
Insurance
Where do you currently get your massage liability insurance? Please check one. *
Education
Massage School & Graduation Date *
Do you hold any other Licenses or practice any complimentary occupations? (Example: Licensed Esthetician, Yoga Instructor, Trainer, Life Coach, etc.) *
Were you referred by a member of USOLMT? *
If yes, what is the referring member's name and referral code? *
What programs are you interested in? Please check all that apply. *
Required
Membership Agreement
Membership will begin upon acceptance of your application and shall continue perpetually, unless otherwise cancelled or terminated. Membership renewal is automatic unless member requests otherwise. The Association reserves the right to modify membership fees and renewal terms upon providing reasonable notice to the Members. Members are entitled to rights and benefits as described in the bylaws. Members agree to comply with USOLMT's Codes of Conduct and Ethics, Bylaws, and Membership Policies.  As a member, you agree to fill out an annual renewal form that includes career status and any changes in contact information. Members shall not engage in any activity that may harm the reputation or interests of USOLMT or its members. We reserve the right to terminate or suspend a membership at any time for cause, including but not limited to non-compliance with this Agreement or violation of the Association's bylaws, rules, or policies.  Members may cancel membership at anytime by filling out the membership cancellation form. Membership fees are generally non-refundable, except as specified in our refund policy. Members agree that the association and all officers, directors, staff and volunteers shall not be held liable for type of damages incurred as a result of your membership or use of our resources, unless willfully caused by misconduct or gross negligence. This agreement is governed by the laws of Arizona. By submitting your membership application, you acknowledge that you have read and understood this agreement and agree to these terms and conditions.  
Do you accept the terms of this agreement? *
Thank you for Joining USOLMT!  Please add bethechange@usolmt.com and usolmt@gmail.com to your accepted email list so we don't go to spam or promotions and you receive your welcome emails and site approval. Next Step: visit www.usolmt.com and set up your site login.  Once approved, you'll have full access and can purchase insurance by visiting Members, choosing Discounts, and following the instructions.  Enjoy your new association!
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