t qu IIII. School of Massage Therapy Initial Application for Admission Name: Date of Application: Address: City, State, Zip code: Date of Birth: Telephone: Email Address: Citizenship: (Home) _J (Work) (Cell) Class applying for: 0 Spring Intensive '09 (5/4/09 Mon-Fri) 0 Summer '09 (8/8/09 Tues, Thurs, Sat.) 0 Fall Intensive '09 (9/14/09 Mon-Fri) Personal References: I) Name (non-relative): Email Address: Telephone: (Home) (Work) 2) Name (non-relative): Email Address: Telephone: (Home) (Work) (Cell) (Cell) Your Occupation: How long at this job? Your Employer (Name) History of Education: High School: (Address) (Phone) (Name) Colleges: (Name) Why do you want to become a Massage Therapist? (City, State) (Graduation Date) (City, State) (Graduation Date) How do you plan to pa for school? El Personal (Upfront Payment in Full) 0 Sallie Mae El Veterans Affairs GI Bill 0 Scholarship/Grant oes not provide any scholarships or grants; Each student is responsible for securing own finances) How did you know abou M , ? 0 Veb Site 0 Natural Healers 0 Other: Enclose $300 non refundable application fee Application deadline is due 5 weeks prior to the first day of class. "Strive for the fligkest" EFTA00776448