Center for Massage & Natural Health® Alumni Resources

Name

Class Select your ClassClass 12-08: December 2008 - May 2009Class 09-08: September 2008 - February 2009Class 06-08: June 2008 - November 2008Class 03-08: March 2008 - August 2008Class 12-07: December 2007 - May 2008Class 09-07: September 2007 - February 2008Class 06-07: June 2007 - November 2007Class 03-07: March 2007 - August 2007Class 12-06: December 2006 - May 2007Class 09-06: September 2006 - February 2007Class 06-06: June-November, 2006Class 03-06: March-August, 2006Class 12-05B: December 7, 2005-June 3, 2006Class 12-05A: December 5, 2005-May 31, 2006Faculty & StaffClass 09-05: September 6, 2005-March 4, 2006Class 06-05: June 6-November 30, 2005Class 03-05: March 6-September 2, 2005Class 12-04: November 29, 2004-May 28, 2005Class 09-04: August 30, 2004-February 24, 2005Class 06-04: June 1-November 23, 2004Class 03-04: March 1-August 26, 2004Class 12-03: December 1, 2003-May 25, 2004Class 09-03: September 2, 2003-March 4, 2004Class 06-03: June 2-November 25, 2003Class 03-03: March 3-August 28, 2003Class 12-02: December 2, 2002-May 29, 2003Class 09-02: September 3, 2002-February 28, 2003Class 06-02: June 3-November 28, 2002Class 03-02: March 4-August 29, 2002Class 12-01: December 3, 2001-May 30, 2002Class 09-01: September 4, 2001-February 28, 2002Class 06-01: June 4-November 30, 2001Class 03-01: March 5-August 31, 2001Class 12-00: December 4, 2000-May 31, 2001Class 09-00: September 5, 2000-March 2, 2001Class 06-00: May 30-November 28, 2000Class 03-00: March 6-August 30, 20001998 and 1999 classes

Mailing Address

City State Select a StateALAKASAZARAEAAAEAEAEAPCACOCTDEDCFMFLGAGUHIIDILINIAKSKYLAMEMHMDMAMIMNMSMOMTNENVNHNJNMNYNCNDMPOHOKORPWPAPRRISCSDTNTXUTVTVIVAWAWVWIWY Zip

Telephone Ex. 000-000-0000

Email Address

Licensure Information

Have you applied for taken passed the National Certification Exam?

If you did not pass, what was your area of weakness?

Have you applied for state licensure? Yes No

Have you received a North Carolina state license? Yes No

Have you received a license from another state? Yes No

If yes, which one(s)?

Student Information

Are you currently a student? Yes No

If yes,

School name

Area of study

Degree/certification

Expected graduation date Ex. MM/DD/YYYY

Employment Information

Are you currently working in an occupation other than massage therapy?
Yes No

If yes, explain.

Are you practicing massage therapy professionally? Yes No

If yes, complete this section:

Self-Employed Yes No

Business Name

Mailing Address

City State Select a StateALAKASAZARAEAAAEAEAEAPCACOCTDEDCFMFLGAGUHIIDILINIAKSKYLAMEMHMDMAMIMNMSMOMTNENVNHNJNMNYNCNDMPOHOKORPWPAPRRISCSDTNTXUTVTVIVAWAWVWIWY Zip

Telephone Ex. 000-000-0000

Employee or Independent Contractor Yes No

If yes, please provide your business(es)' information.

Business 1:

Business Name

Mailing Address

City State Select a StateALAKASAZARAEAAAEAEAEAPCACOCTDEDCFMFLGAGUHIIDILINIAKSKYLAMEMHMDMAMIMNMSMOMTNENVNHNJNMNYNCNDMPOHOKORPWPAPRRISCSDTNTXUTVTVIVAWAWVWIWY Zip

Telephone Ex. 000-000-0000

Business 2:

Business Name

Mailing Address

City State Select a StateALAKASAZARAEAAAEAEAEAPCACOCTDEDCFMFLGAGUHIIDILINIAKSKYLAMEMHMDMAMIMNMSMOMTNENVNHNJNMNYNCNDMPOHOKORPWPAPRRISCSDTNTXUTVTVIVAWAWVWIWY Zip

Telephone Ex. 000-000-0000

Business 3:

Business Name

Mailing Address

City State Select a StateALAKASAZARAEAAAEAEAEAPCACOCTDEDCFMFLGAGUHIIDILINIAKSKYLAMEMHMDMAMIMNMSMOMTNENVNHNJNMNYNCNDMPOHOKORPWPAPRRISCSDTNTXUTVTVIVAWAWVWIWY Zip

Telephone Ex. 000-000-0000

Which of the following describes your work setting? (Check all that apply)

Massage Office or Clinic
Your Home
Spa/Day Spa
Health/Sports Club
Medical Office/Hospital
Chiropractor's Office
Rehabilitation Center
Beauty Salon
Resort
Cruise Ship
Outcall Service
Other

What is your average # of massages/week?

If you are not currently practicing massage,

Are you uninterested or unable to professionally practice massage therapy at this time? Yes No

If yes, please explain.

Are you currently unemployed (not working in any occupation)?
Yes No

If yes, explain.

Center for Massage & Natural Health Feedback

Would you like our assistance with finding a massage therapy job?
Yes No

Name any subjects for massage therapy continuing education that you are interested in studying but do not see on our current workshop calendar:

Are you satisfied with the training you received through our Massage Therapy Certification Program? Yes No

If your work/life experience since graduation has given you any new insight into the strengths and weaknessess of our program, please share: