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MASSAGE LICENSING PROGRAM REGISTRATION FORM

I am registering for your 541 Hour Massage Certification Training Program.

*See school syllabus pertaining to the program you are registering for.

Upon receipt of a $100.00 registration fee, you will be contacted with information pertinent to the above class dates, books and materials required for the program. Registration fees are non-refundable after five business days and provided you have not commenced training.

REGISTRATION FEE IS NON-REFUNDABLE AFTER FIVE WORKING DAYS

MAKE CHECK PAYABLE TO: BELLEVUE MASSAGE SCHOOL SEND THIS FORM WITH CHECK TO:

BELLEVUE MASSAGE SCHOOL
Attn: Merritt Furman
15921 N.E. 8th, Ste. C106
Bellevue, WA 98008
(425) 641-3409

Download a printable version of the form here or fill out this online form below:

Check the course you wish to enroll in *
Mornings - Mon, Wed & Fri
(Approximately 2 Saturdays/Month)
Hours 8:00am - 12:50pm 
Evenings - Mon, Wed & Fri
(Approximately 2 Saturdays/Month)
Hours 5:25pm - 10:15pm 
Starting Month
Starting Year
Name *

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Last
Address *

Street Address

Address Line 2

City
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Phone Number *

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Email *

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