Apply Start your new career today. Apply Now Please complete the form below. "*" indicates required fields Application Date* MM slash DD slash YYYY Class Date* MM slash DD slash YYYY Applying for*Resident Program600 HR MassageContinuing Education ProgramsContinuing Education Program ChoiceSelf CareAroma TherapyMyofascial ReleaseTrigger Point TherapyReflexologyLymphatic DrainageName* First Last Address* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Email Address* Home Phone*Cell PhoneWork PhoneEmployerWork HoursSupervisor NameLevel of Education CompletedHave you ever been convicted of a felony?*YesNoDo you have any disabilities that may complicate performing massage?YesNoIf yes, please explain.Are you Free of contagious diseases?*YesNoI hereby authorize A Servants Hands School of Massage Therapy to verify that all above statements and answers are true and correct*Start signing your signature hereCAPTCHA See More Other Agreements Enrollment Agreement Payment Plan
