Email

Street Address

City

State

Cell Phone

Education / Special Training (beginning with High School)

School 1 Name

School 1 City & State

Diploma / Degree

Major

School 2 Name

School 2 City & State

Diploma / Degree

Major

Work Experience

Company 1 Name

Company 1 Address

Title & Duties

Company 2 Name

Company 2 Address

Title & Duties

Do you have experience or training in any type of massage? If yes, please explain:

Briefly discuss your interest in taking this program:

Briefly outline your career goals:

Provide two references (include name, title, address, phone, and relationship to you):

Programs & Classes

Preferences (please provide any additional notes regarding your preferences for the programs and classes above, if necessary):

Signature and Application Fees

Full Name

By submitting this application, I verify that the above information is, to the best of my knowledge, true and correct.

To finalize this application, please send $25.00 Non-Refundable Application fee to AIMT. A current valid government issued photographic identification is required for enrollment. The fee can be mailed or dropped off to the school at: American Institute of Massage Therapy 1516Brookhollow Dr., Unit C Santa Ana, CA 92705

AIMT Application

American Institute of
Massage Therapy

Resources

AIMT Application

American Institute ofMassage Therapy

Resources

American Institute of
Massage Therapy