Application for Thai Massage Therapy Specialist Program

I’m so happy that you are interested in joining one of my Thai manual therapy training programs. Please fill out the form below and I will get back to you to schedule a time to chat. It is important to me to do my best to make sure that this is a good fit for you.

Name

First Name

Last Name

Pronouns

Phone Number

Address

City, State and Zip Code

Date of birth

You must be 18 or older to participate in classes

YYYY

Please tell me what, if any, prior Thai massage training you have had

Please tell me a little bit about your interest in this program. What brings you to study Thai healing arts in-depth?

Students from all walks of life and religious or non-religious backgrounds are welcome in this course, but it's good to know that Thai medicine is rooted in Buddhist teachings and class will include Thai spiritual ceremonies. Do you have any questions or concern with this that we might want to chat about?

Do you have any limitations or learning differences or concerns about your ability to participate in this program that you want to discuss?

Do you have a device that we can have a Zoom or Skype meeting on?

Yes

No (if no, we will schedule a phone appointment)

Disease mitigation protocol agreement

I have read and agree to your covid/disease mitigation policies and will adhere to any and all still in place at time of in-person workshops

Is there anything else you would like to share here?

I welcome students of all races, genders, religions, sexual orientations and political affiliations. Decisions about applications are solely based on making sure that it seems like the potential student will be able to thrive in this training while being good community to everyone in their cohort.