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Please
print, complete (in legible black ink printing), & sign this
Certified
Massage Therapist certification application,
along with the signed Certified
Massage Therapist
Code of Ethics, scan both documents, and then email both this
application and the signed Code of Ethics to the Certified Massage
Therapists International Society by email attachment to: massagedirectory@yahoo.com,
&
make your payment.
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 |
