Massage Certification Application Application online to apply for massage certification course at Asheville School of Massage and Yoga. Step 1 of 5 20% Massage Program Selection*500-Hour Program July Start675-Hour Program April Start675-Hour Program October StartName* First Last Please register with the exact name you would like to appear on your certificateMailing Address* Street Address City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAntigua and BarbudaArgentinaArmeniaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBrazilBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCosta RicaCôte d'IvoireCroatiaCubaCuraçaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEast TimorEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFaroe IslandsFijiFinlandFranceFrench PolynesiaGabonGambiaGeorgiaGermanyGhanaGreeceGreenlandGrenadaGuamGuatemalaGuineaGuinea-BissauGuyanaHaitiHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJordanKazakhstanKenyaKiribatiNorth KoreaSouth KoreaKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMauritaniaMauritiusMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew ZealandNicaraguaNigerNigeriaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaSaint Kitts and NevisSaint LuciaSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSpainSri LankaSudanSudan, SouthSurinameSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTogoTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.YemenZambiaZimbabwe Country Email* Enter Email Confirm Email Primary Phone*Secondary PhoneDate of Birth* Where did you hear about the Asheville School of Massage & Yoga? Citizenship*US CitizenNon-US CitizenCurrent State of Residence*Visa Issued By*Have you ever been convicted of a felony or misdemeanor (excluding traffic violations)?*NoYesPlease provide a brief description of the felony or misdemeanor.Current Occupation*Previous Occupation*Previous Education* High School GED Certificate College How many years of college did you attend? Emergency Contact InformationContact Name* First Last Contact Phone Number*Contact Relation (Mother, Husband, etc.)*Personal ReferencePlease list someone who has known you for at least a year and can speak about your character. No direct family members please.Personal Reference Name* First Last Your Relationship (boss, church member, colleague, etc.)*Personal Reference Phone*Personal Reference Email Professional ReferencePlease list someone with whom you have worked with (paid or volunteer) and can speak about your professionalism.Professional Reference Name* First Last Professional Reference Title (Licensed Massage Therapist, Physician, Yoga Instructor, etc.)*Professional Reference License NumberProfessional Reference Phone*Professional Reference Email Briefly tell your personal experience with massage, including why you want to attend massage school.*Briefly describe your experience with yoga, and tell why you are interested in yoga as a component to your massage therapy education.*How do you learn best? How have your past learning experiences (both formal and informal) served you or disappointed you? Do you have any learning disabilities or special needs?*Describe your emotional and physical readiness to fully participate in our program. (If you are unclear about this statement, please make an appointment to talk with a staff member.)*How do you take care of yourself physically, emotionally, and spiritually? How will you continue to do this as you begin your education in massage therapy? What tends to sabotage your self-care, and how do you address that?*What has been your experience with personal counseling/therapy?*Briefly tell about your experience with meditation and mindfulness practices.*How do you plan to meet your tuition requirements and take care of yourself financially while you are in school? Please be specific.* Additional DocumentationIn addition to your application, please submit the following items:Proof of Age*Email to [email protected]Mail to: 707 Haywood Rd. #001 Asheville, NC 28806Upload NowCopy or photo of Driver’s License or Birth Certificate. Must be 18 years or older to apply.Upload Proof of Age*Accepted file types: jpg, gif, png, pdf.High School Equivalency*Email to [email protected]Mail to: 707 Haywood Rd. #001 Asheville, NC 28806Upload NowCopy or photo of your high school diploma, college diploma, or GED certificate. Unofficial transcripts showing graduation date are also acceptable.College or High School Diploma*Accepted file types: jpg, gif, png, pdf.Payment Options*Pay by credit cardPay by check/money orderThere is a $50 application fee.Application Fee Price: $50.00 Total $0.00 Credit Card* American ExpressDiscoverMasterCardVisa Card Number Month010203040506070809101112 Year20162017201820192020202120222023202420252026202720282029203020312032203320342035 Expiration Date Security Code Cardholder Name Payment must be received in order to begin processing your application. Please mail payment to: Asheville School of Massage & Yoga Admissions 707 Haywood Road, Suite 001 Asheville, NC 28806Once the school has received your application and all of the items listed above, a school official will call you to arrange an interview to complete the admissions process. If you are accepted to the program, an official letter of acceptance will be sent to you after your interview. This iframe contains the logic required to handle AJAX powered Gravity Forms.
