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842 Hour - Certificate of Massage Therapy
It takes just two steps to enroll and save your spot!
1) Complete and submit this enrollment form
2) Complete a tuition down payment of at least $800
Along with filling out this form, it is essential to make a tuition down payment (minimum of $800) to secure your spot in an upcoming class. Your application will only be processed after your payment has been successfully completed. Payments can be made at our office, over the phone *517-759-5040*, or by PayPal at
www.paypal.me/adrianschoolofmassag
. Please remember to include your name and "TUITION" in the memo line to ensure accurate processing.
Sections of this Enrollment Form Include:
1) Your Information
2) In Case of Emergency
3) Completed Education
4) Background References
5) Essay and Application Intent
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Your Information
Legal First Name:
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Legal Last Name:
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Preferred Name:
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Pronouns:
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For which cohort are you applying?
(*leave blank if next available)
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Primary Phone Number:
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Secondary Phone Number:
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Primary Email:
(*This will be used for your online log-ins. Please use an email you anticipate always having access to.)
*
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Alternate Email:
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Mailing Address:
*
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City
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State:
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Zip:
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Birth Date:
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Current Occupation:
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Employer:
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Employer/Supervisor Contact Information:
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Please list any health concerns ASM should be aware of:
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