Therapist Program Enrollment Form

Please send $25.00 registration fee to complete your registration. You will be contacted by phone to set up an interview. Send to:

Marquette School of Therapeutic Massage
307 South Front Street
Marquette, MI 49855

625 Clock-Hour Massage Therapist Program

Which class do you want to attend?*
- Fall 2019
- Fall 2020
Name*
First Middle Initial Last
Address*
Street Address City State Zip
Home Phone*
Work Phone
Email*
Date of Birth*
Date Format: MM slash DD slash YYYY
Person to contact in case of emergency*
First Last
Emergency contact phone #*
Have a high school diploma or G.E.D. equivalent?*
- Yes
- No
Have you ever had a professional massage before?*
- Yes
- No
Do you have any medical condition(s) or infectious diseases? If so, please specify
Electronic Signature*
- I have read and understand all policies and procedures in the catalog
The tuition and fees paid by the applicant shall be refunded if the applicant is rejected by the school before enrollment. An application fee of not more than $25.00 may be retained by the school if the application is denied. All tuition and fees paid by the applicant shall be refunded if requested within three business days after signing a contract with the school. All refunds shall be returned within 30 days. Once the 3 business days have elapsed the following policies will apply: The entire enrollment deposit made will be refunded if the applicant drops out anytime up to 2 weeks prior to orientation. After that a refund will be granted only if there is another applicant waiting to fill that class space. Once 2 weeks prior to orientation occurs no refunds will be given.
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Phone
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