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Santa Fe, New Mexico
Formerly named the Scherer Institute of Natural Healing
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Your Email
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Semester Applying For
Fall
Spring
Massage Therapy Certification Programs
Full-time 700-hour
Date of Birth
*
Date Format: MM slash DD slash YYYY
Place of Birth: City, State, Zip
*
Dependents Names and Ages
Dependent 1
Dependent 2
Dependent 3
Professional reference to provide character references (Name, Relationship, Phone, Address)
Reference 1
Reference 2
Name of someone to be notified in case of an emergency (Name, Relationship, Phone)
Emergency Contact 1
Emergency Contact 2
Are you a US Citizen?
*
Yes
No
Immigration status if not a US Citizen
The information on this form is true and complete to the best of my knowledge. I certify that I have received and read a copy of the current catalog. I agree to not hold the school, instructors, or students responsible for any injury caused due to my failure to disclose any medical conditions. Should there be any change in the content of the information I have given here, including my medical condition, I will immediately notify the administration and/or instructors.
Signature (type full name)
*
Health Information
1. Please describe any previous or current medical or psychological conditions that might affect your performance as a student and future massage therapist. Please include surgeries or injuries.
*
2. Are you currently receiving medical or therapeutic treatment of any kind?
*
3. Are you taking medication regularly? (We will request your written permission to speak with your health care provider if necessary.)
*
4. Do you have any challenges or difficulties with regard to the learning and classwork?
*
Essay Questions
5. Write about your educational history, both formal and informal.
*
6. What experiences have you had with massage and/or other healing arts?
*
7. Discuss your short- and long-term goals, explaining how attending massage school is relevant.
*
8. What are your strengths as a student?
*
9. Describe what you foresee as the main challenge or obstacle that you may have to work through to become an effective therapist.
*
10. Write about your experience with groups. Describe how you participate.
*
11. Write about your financial situation, how you plan to support yourself, and how you will pay tuition.
*
12. If you are applying for the Certification course and have ever been convicted of a felony, please contact us directly, as it may determine your eligibility for massage licensure.
*
13. How did you hear about Santa Fe School of Massage, and what made you decided to apply to this school?
*
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