Continuing Education Application

indicates required fields

Personal Information

First Name *

Middle Name

Last Name *

Street Address *

Address continued

City *

Zip *

State *

Home Phone # *

( )

Work Phone #

( )

Additional Phone #

( )

Email *

Current Occupation

Date of Birth *

MT License #

Are you a US Citizen or Legal resident? YesNo

How did you hear about us?

Other

Are you interested in our graduate-level program to become a Certified Somatic Therapist? YesNo

Have you graduated from a 500-hour minimum Certified Massage Therapy program? YesNo

2012 Course Offerings

Board Review $90 Instructor: Jeremy Taylor Tuesday 1/31/12 @ 8:30PM - 10:30PM & Thursday 2/2/12 @ 6:30PM - 10:30PM Wednesday 2/22/12 @ 9:30AM - 4:30PM Tuesday 5/1/12 @ 6:30PM - 10:30PM & Tuesday 5/8/12 @ 6:30PM - 10:30PMWednesday 5/23/12 @ 9:30AM - 4:30PM

Reiki 2 (Instructor: Michal Spiegelman) $250 Reiki 2 March 4, 2012 6CE Saturday 11am to 5pm

Reiki Master (Instructor: Michal Spiegelman) $650 April 22, 2012 6CE Saturday 11am to 5pm

Massage Therapy for Cancer Clients (Instructor: Alissa Boucher)$525 March 9, 10 & 11, 2012 24CE Friday Saturday & Sunday 9am to 6pm

AN EXPERIENTIAL INTRODUCTION TO BODY PSYCHOTHERAPY (Instructor: Dr. Jerry Epps) $250 March 10 & 11, 2012 12CE Saturday & Sunday 9am to 4pm

CranioSomatic Foundations (Instructor: G.Dallas Hancock, D.C.,Ph.D. and Florence‘Flo’ Barber-Hancock, LMT, Ph.D.) $295 CranioSomatic Foundations 2 February 25&26, 2012 16CE Saturday & Sunday 9am to 6pm $50 discount when you register for two courses (Example: If you take CranioSomatic Foundations 1 & 2 you will receive a $50 discount)

CranioStructural Integration - 1 & 2 (Instructor: G.Dallas Hancock, D.C.,Ph.D. and Florence‘Flo’ Barber-Hancock, LMT, Ph.D.) $325 CranioStructural Integration 1 March 24 & 25, 2012 16CE Saturday & Sunday 9am to 6pmCranioStructural Integration 2 April 21 & 22, 2012 16CE Saturday & Sunday 9am to 6pm $60 discount when you register for both courses (Example: If you take CranioStructural Integration 1 & 2 you will receive a $60 discount)

Chair Massage (Instructor: Carl Christie)$250 March 17 & 18, 2012 12CE Saturday & Sunday 9am to 4pm

Active Isolated Stretching (Instructor: John Howard) $550 April 12, 13, 14 & 15, 2012 32 CE Thursday - Sunday 9am to 6pm $55 discount when you register before 3/29/12

Holographic Assessment & Body Balancing (Instructor: Ann Pauley) $395 May 4-7, 2012 30CE Friday, Saturday, Sunday & Monday 9:00am to 6:00pm

Pre and Perinatal Massage Therapy (Instructor: Carol Osborne d.b.a. Body Therapy Associates) Pre and Perinatal Massage Therapy: $695 ( $595 when you register before 10/08/12 ) Required Textbooks Textbooks must be purchased in addition to tuition. Pre- & Perinatal Massage Therapy 2nd Edition $44.95 http://bodytherapyassociates.com/prodview.php?id=14

Clinical Sports Massage Therapy 150CE $2,250 (plus clinic hours Fri., Sat. or Sun.) Day: April 18, 2012 – July 23, 2012 (Classes are on Mon., Tue., Wed. and/or Thur. from 9:30 to 12:30 and/or 1:30 to 4:30 and vary each week) 9:30am to 12:30 and/or 1:30 to 4:30pm WikelNight: June 11, 2012 – November 19, 2012 (Classes are on Mon., Wed., and Sat. from 6:30 to 10:30 and Sat. 9-1 or 2-6pm and vary each week) 6:30pm to 10:30pm Sat. 9am - 1pm Tucker

Neuromuscular Therapy 230CE $3,450 (plus clinic hours Fri., Sat. or Sun.) Day: April 5, 2012 to August 8, 2012 Tues. & Thurs. 9:30am to 4:30pm Davis Day: June 28, 2012 to October 31, 2012 Tues. & Thurs. 9:30am to 4:30pm EubanksNight: April 10, 2012 – October 4, 2012 Tues. & Thurs. 6:30pm to 10:30pm Sat. 9am to 1pm and 2pm to 6pm Dr.BlessingNight: August 14,2012 – February 7, 2013 Monday & Wednesday 6:30pm to 10:30pm Sat. 9am to 1pm and 2pm to 7pm Nadel

Please complete your application by making a non-refundable $50 application fee through PayPal. This Is Not An Additional Payment, the Non- Refundable $50 goes towards your Balance and Holds your Spot for that class. * I understand