IBSMT Application

Online Admissions application

Please complete the entire application.
Your Name*

First NameLast Name
Your E-mail Address*
example@example.com
Phone Number*
Best way to contact you?

Phone callText messageEmailMail
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Birth Date*

MonthDayYear
Emergancy Contact information
Contacts Name*

First NameLast Name
Relationship
Emergency Contacts Phone Number*
Educational History
Highest Grade Completed:*
Name of last School Attended*
Do you have any physical or emotional condition which would prevent you from giving/receiving a massage or performing any adjunct procedure or walking to/from class?*

NoYesi don't know
Have you ever been convicted of a felony?*

NoYes
Course Selection

Pick your preferred program and Schedule
Please choose a Program.*
Please choose a scheduling option.*
Desired enrollment date.*
Please read before submitting application

I certify that the information within this application is current and true. I understand that, if accepted, falsified statements in the application shall be grounds for immediate dismissal. I understand that all students of IBSMT are required to attend weekend classes as scheduled.
Should be Empty:

Online Admissions application