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name:________________________________________________________________ ________________________________________________________________________ City:_____________________________ State: ________________ Postal Code: _____ Country:__________________ Daytime phone: (________ )______________________ Email address:____________________________________________________________ I herein apply to be trained and designated by the Certified Massage Therapists International Society (CMTIS) as a Certified Massage Therapist (C.M.T.). If I am accepted for C.M.T. certification by the CMTIS, I will always follow and abide by the CMTIS Code of Ethics. I understand and agree that my Certified Massage Therapist designation will be terminated by the CMTIS if I violate the CMTIS Code of Ethics. To accompany this certification application, I will make the certification fee payment of US$99 by using one of the Payment Options.
If
you have completed ANY college, trade, vocational school, or technical
education programs for massage therapy, please provide the details including
school name, school location, year of graduation or completion of course,
subjects studied, and any other helpful info. Attach extra sheets of paper
if needed.
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Print This Page Full name:_________________________________________________________________ Mailing address:____________________________________________________________ _________________________________________________________________________ City:_____________________________ State: ________________ Postal Code: ________ Country:__________________ Daytime phone: (________ )_______________________ Email address:______________________________________________________________
I herein apply to be trained and designated by the Certified Massage Therapists International Society (CMTIS) as a Certified Massage Therapist (C.M.T.). If I am accepted for C.M.T. certification by the CMTIS, I will always follow and abide by the CMTIS Code of Ethics. I understand and agree that my Certified Massage Therapist designation will be terminated by the CMTIS if I violate the CMTIS Code of Ethics. To accompany this certification application, I will make the certification fee payment of US$99 by using one of the Payment Options. If you have completed ANY college, trade, vocational school, or technical education programs for massage therapy, please provide the details including school name, school location, year of graduation or completion of course, subjects studied, and any other helpful info. Attach extra sheets of paper if needed. ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ Please describe in detail all or your massage therapy business/work/job/career experience. Please include details such as massage therapy skills learned, massage therapy services provided by you, employment dates, and employer names and addresses. Attach extra sheets of paper if needed. ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ I certify that the above information is totally true and complete. ___________________________________ __________________ My Signature Date |
