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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 #: |
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2. CONTACT DETAILS | |||
Email Address: | Home Telephone Number: | Work/Cell Number: | |
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Residential Address: | Mailing Address: | ||
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City: | City: | ||
State/Zip: | State/Zip: | ||
3. ACADEMIC BACKGROUND | |||
Date | Institute | Documentation | |
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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.
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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
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Applicant’s Signature Date
OFFICE USE ONLY
Date of Interview: | Interviewed By: |
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