Application

Please complete the application form below and an AIMT representative will be in touch with you soon. You can also download and complete the form here.

AIMT Application

Contact Information

Your Name (required)

Email (required)

Street Address (required)

City (required)

State (required)

Cell Phone

Date of Birth

Education/Special Training (begin with high school)

School 1 (name):

School 1 (city, state):

From:

To:

Diploma/Degree:

Major:

Did you graduate?:

School 2 (name):

School 2 (city, state):

From:

To:

Diploma/Degree:

Major:

Did you graduate?:

Work Experience (begin with your most recent job):

Company 1 (name):

Company 1 (address):

From:

To:

Title and Duties::

Company 2 (name):

Company 2 (address):

From:

To:

Title and Duties::

Do you have experience or training in any type of massage? If yes, explain:

Briefly discuss your interest in taking this course:

Briefly outline your career goals:

Provide two references (name, title, address, phone, relationship to you):

Programs & Classes

Please select the program you consider and class, and month which best suit your schedule. If more than one, indicate the order of preference

Programs: Massage Therapist – 624 HoursMassage Therapy/Sports Massage Therapist – 1,029 Hours

Classes:

Monday/Wednesday (DAY Class), 9:00 AM - 4:30 PM (Jan., March, May, July, Sep., Nov.)Tuesday/Thursday (DAY Class), 9:00 AM - 4:30 PM (Jan., March, May, July, Sep., Nov.)Saturday/Sunday (DAY Class), 9:00 AM - 4:30 PM (Jan., March, May, July, Sep., Nov.)Monday to Thursday (NIGHT Class), 6:45 PM-10:00 PM (Jan., March, May, July, Sep., Nov.)

Preferences (please provide any additional notes regarding your preferences for the programs and classes above, if necessary):

Signature and Application Fees

Full Name (required):

Date (required):

I state that the above information is to the best of my knowledge true and correct.

To finalize this application, please send $25.00 Non-Refundable Application fee to AIMT. A current valid government issued photographic identification is required for enrollment.

The fee can be mailed or dropped off to the school at:
American Institute of Massage Therapy
1516Brookhollow Dr., Unit C
Santa Ana, CA 92705

AIMT Application

Contact Information

Education/Special Training (begin with high school)

Work Experience (begin with your most recent job):

Programs & Classes

Signature and Application Fees

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AIMT Application

Contact Information

Education/Special Training (begin with high school)

Work Experience (begin with your most recent job):

Programs & Classes

Signature and Application Fees

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