| Body and Soul Theraputic Massage School Online Course Application Form |
| *Please note: all fields are required |
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| Please check one of the following: |
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| Last name: |
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| First name: |
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| Address: |
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| City: |
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| State: |
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| Zip: |
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| Home phone: |
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| Work phone: |
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| Email address: |
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| Date of birth: |
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Male
Female |
| Emergency contact: |
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| Phone: |
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| Relationship: |
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| Educational Background |
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| Please list the name of the institution(s), date(s) attended, and degree/certificate |
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| Work Experience |
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| List your last two employers starting with the most recent |
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| Employer |
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| Job title |
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| Phone number |
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| Start date (month / year) |
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| End date (month / year) |
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| Reason for leaving |
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| Job description |
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| 2. |
| Employer |
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| Job title |
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| Phone number |
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| Start date (month / year) |
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| End date (month / year) |
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| Reason for leaving |
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| Job description |
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* Please provide the following documents and mail them to Body and Soul Theraputic Massage School
1. A copy of your high school diploma or GED equivalent.
2. A copy of any other diplomas, certificates, or licenses of additional education.
3. A letter from a health professional stating that you are in good physical, mental and emotional health and are physically able to give and receive massage with no adversity to your well being.
4. Two letters of recommendation from an employer, teacher, or a health care professional (general physician, chiropractor, massage therapist, etc.). |
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