ABOUT YOU

Which Campus Do You Want To Attend? *:*

*For first year please choose Spa Massage Practitioner
for second year, please choose Massage Therapy Diploma.

Course Selection:*
First Name:*
Last Name:*
E-Mail:*
Phone Number:*
Address:*
City:
Country:*
Province/State:*
Postal/ZipCode:
Birth Date:

PREVIOUS EDUCATION

Is English Your First Language?
Last High School Attended:
High School Location:
Highest Grade Year Completed:
High School Grad Date
Have you attended a post secondary institution?

If you answered Yes, please fill out the information below:

Post Secondary Institution:
Post Secondary Program:
Post Secondary Program Start Date:
Post Secondary Program End Date:
What Status Did You Leave In?
Do you have a criminal record?
What are you career goals?
Why does Massage Therapy interest you?
How did you hear about us?*
Please Specify:
By submitting this form, I agree that Alberta College of Massage Therapy may call, text and/or email me about their educational services