Join us & become a licensed massage practitioner

I declare that all of the informations provided below and in any supporting documents are accurate. By summiting this form, I hereby pledge to abide by the Code of Ethics.

Full Name (must match your ID cards)




Address (Where should we mail your certificate)

School Attended (name of school, address, year of completion)

Total Academic Hours Completed (please provide copy of certification)

Total Number of Massage Performed (please provide copy of supported document)

Refferal By (who told you about our association?)