1. Please contact us for an application via e-mail
or
2. Right click + print to print document.
Serenity Now School
of Massage
1015 N. 6th
Street, Wausau, WI 54403 Tel:
715-842-1772
Email: Serenity_Now_School_of_Massage@yahoo.com
APPLICATION FOR
ADMISSION
1.
PERSONAL DETAILS
|
Title:□Mr. □Miss □Mrs. □Other:
|
Date
of Birth:
|
Last
Name:
|
DD/ MM/ YY
|
First
Name:
|
Gender:
|
Other
Names:
|
□Male
□Female
|
Social
Security #:
|
|
2. CONTACT DETAILS
|
Email
Address:
|
Home
Telephone Number:
|
Work/Cell
Number:
|
|
|
|
Residential
Address:
|
Mailing
Address:
|
|
|
City:
|
City:
|
State/Zip:
|
State/Zip:
|
3. ACADEMIC BACKGROUND
|
Date
|
Institute
|
Documentation
|
|
|
□Attached
□To Follow
|
|
|
□Attached
□To Follow
|
|
|
□Attached
□To Follow
|
|
|
□Attached
□To Follow
|
4. STUDENT DECLARATION
|
|
|
|
|
I would like
to choose the following month to start the program: (please circle)
- February
- April
- July
- November
I hereby
certify that information entered above is correct and complete. I understand that false information will
invalidate this application. I have read
and understand the school catalog. I
understand the refund policy and that I may cancel my application by notifying
the school within 3 business days of submission for a full refund of all
tuition paid.
This
application for admissions must be accompanied by:
- $100 application fee
- Copy of your high school diploma,
GED, etc.
- Statement from a medical professional
that you can safely participate in this massage therapy course.
- Resume or short statement
including your educational and employment history
- Cover letter introducing yourself
and your reason(s) for choosing to enter a massage therapy program.
- Proof of professional massage.
*All class
dates and times are subject to modification depending on enrollment.
_______________________________________________________________________
Applicant’s Signature Date
Buyer’s
Right to Cancel:
The
student has the right to cancel the initial application agreement until
midnight of the fifth business day after the student has been accepted into the
program (i.e., the date the school has co-signed the enrollment
agreement). If the information about the
Buyer’s Right to Cancel is not provided in writing to the prospective student,
the applicant has the right to cancel enrollment at any time and receive a
refund of all monies paid to date within 10 days of cancellation. The “Buyer’s Right to Cancel” information is
stated on the back of the enrollment agreement.
Acknowledgment
of receipt of School Catalog dated: 3/2/16
_______________________________________________________________________
Applicant’s Signature Date
OFFICE USE ONLY
Date
of Interview:
|
Interviewed
By:
|
|
|
Accepted:□Yes □No
Comments:
|
|