Online Application Form

Please contact us at (850) 269-0820 if you haven’t heard back from us within 72-hours from submission.

    Please complete each section of this application. Any falsification is grounds for rejection or for cancellation of enrollment agreement. This information is strictly confidential.

    Personal Data

    Last Name

    First Name

    Middle

    Maiden Name

    ID#/DRV Lic. #

    Email

    Address

    Apt #

    Zip Code

    Telephone

    U.S. Citizen?
    YesNo

    Alien Registration No.

    Name as you want it to appear on your Certificate

    Nearest Relative (Excluding spouse, or other relative living with you)

    Relative's Name

    Relationship

    Emergency Contact

    Emergency Contact Name

    Relationship

    Emergency Contact Address

    City

    State

    Zip

    Day Phone

    Evening Phone

    How did you hear about Soothing Arts? (check all that apply)
    InternetSignsYellow PagesRadioFlyerFriendEventOther

    Current Employment

    Are you currently employed?
    YesNo

    Address

    City

    State

    Zip

    Position

    How Long

    Education and Training

    General Requirements:
    Florida LAW requires that all students and licensee applicants for a massage therapy license must have a high school diploma or equivalency. Please provide transcript, diploma or GED Certificate.

    References

    (Please fill in all information, and use references you have known for at least three years)

    Name

    Mailing Address & No. Street

    City, State, Zip

    Phone

    Name

    Mailing Address & No. Street

    City, State, Zip

    Phone

    Name

    Mailing Address & No. Street

    City, State, Zip

    Phone

    Name

    Mailing Address & No. Street

    City, State, Zip

    Phone

    Other

    Program of Interest
    Massage TherapySkin CareClinical Skin CareNail Specialist

    Do you have previous experience in the health care or beauty industry?
    YesNo

    If yes, please explain

    Other than traffic violations, have you ever been convicted of a crime?
    YesNo

    If yes, please explain

    Will you need financial assistance through a payment plan?
    YesNo

    What hours can you attend classes?

    When can you begin your training?

    Do you have any physical health problems that may interfere with your ability to participate in class?
    YesNo

    If yes, please explain

    If you are applying for the massage therapy program, do you have any physical health problems that may interfere with
    your ability to give or receive massages?
    YesNo

    If yes, please explain

    Below or on a separate sheet of paper, explain your personal and professional goals and how they relate to your chosen
    field of study. Why are you choosing to attend this program?

    Special Accommodations

    Students with special needs due to disability should advise the school prior to enrollment to assure that reasonableaccommodations can be made to facilitate training. Please describe your needs:

    Soothing Arts Healing Therapies School of Massage reserves the right to deny admission to any applicant who does not demonstrate the ability to benefit from the training program, or who does not demonstrate the ethical standards required of the profession for which the training is offered.

    Full Name

    By checking, I certify that the information provided herein is true and accurate to the best of my knowledge. I also state that I have read and agree to abide by the policies stated in the School catalog. If accepted, I agree to uphold the ethical standards required of the profession for which I am being trained.