952 - 562 - 5200
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Where East Meets West
in the Healing Arts.

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First Name
Last Name
Email
Phone
 

Application for Admission

Congratulations on taking the first step toward becoming a professional bodyworker! We’re excited to review your application with you.
Let’s start by determining what interests you.

Which program(s) interest you?
East West Therapeutic Bodywork, AASTherapeutic Massage DiplomaShiatsu Therapy DiplomaMassage Practitioner Certificate
When would you like to start?
Year:      Fall (September)Winter (January)Spring (May)
Which schedule would work best for you?
Full Time / Daytime classesPart Time / Evening classes
Which Elective Courses interest you?
Craniosacral TechniquesBirth Doula & Bodywork TherapyHealth Restorative Bodywork TherapySpa & Resort TechniquesFoot & Hand ReflexologyThai MassageAdvanced Asian Bodywork Therapy
Great! We look forward to discussing these possibilities with you. Next, please tell us about yourself!
Contact Information. Please complete all information.

First Name

Last Name

MI

Day Phone

Evening Phone

Address

Cell Phone

City

State

Zip

Email
Applicant Information. Please complete all information.

Birth Place

Birth Date

Age
Gender     MaleFemale
US CitizenNon-US Citizen, Permanent ResidentNon-US Citizen, Non-Resident
Citizenship

Other Country Citizenship

Current Employer

Employment Length

Employment Position

Employment Supervisor
Education. Please list high school, college, university, vocational training and bodywork training.

High School/GED

City

State

Year of Graduation/Completion

High School/GED

City

State

Year of Graduation/Completion

High School/GED

City

State

Year of Graduation/Completion

Other Professional Training, include Dates
Personal Character References. List the name, phone number & relationship to you of two references below. At least one must be an academic or professional reference who has known you as a student or in a business or professional capacity. Family members & friends may not be used as references.

Full Name

Phone

Relationship

Full Name

Phone

Relationship
Have you ever been charged and / or convicted of a felony or criminal misdemeanor? *

Licensing Requirements

Licensing requirements for professional massage and shiatsu vary from state to state. Licensing requirements may restrict our ability to accept applications from individuals who have been convicted of certain felony or criminal offenses, particularly as they relate to the practice of massage and shiatsu therapy.

*Answering "Yes" does not disqualify the applicant for admission to CenterPoint

YesNo
If Yes, please explain.
I declare that all information provided on this application is true to the best of my knowledge. I Agree
Thank you for your application! We will be contacting you soon to discuss your next steps. In the meantime, please complete steps 1 & 2 on Application Part B and tell us more about your vision for your future!

Please be aware that your application is not official until you submit your $50 application fee. This fee is nonrefundable.
How do you plan to pay your application fee?
I would like to pay online.I plan to send a check.I prefer to pay in person when meeting with admissions.

 

Welcome to CenterPoint Massage & Shiatsu Therapy School & Clinic

CenterPoint | Ph. 952-562-5200

5300 West 35th Street

Minneapolis, MN 55416

Email : Admissions@CenterPointMN.com

    

Call us today at 952-562-5200!