LEMI APPLICATION FORM

Pre-Application for Admission

An official high school transcript, GED certificate, or High School Equivalency (HSE) certificate, with a minimum grade point average (GPA) of 2.0, is required.
Personal Data

Tell us about yourself
Full Legal Name*

First NameMiddle InitialLast Name
Home Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Date of Birth*

MonthDayYear
Cell Phone*
Format: (000) 000-0000.
Home Phone
Format: (000) 000-0000.
Email Address*
Where the confirmation will be send to
Preferred Name:
Preferred Method of Contact*

EmailPhoneText
Preferred pronouns (choose all that apply)*

SheHerHeHimTheyThemOther
If not listed, please indicate preferred pronouns:
Accommodations and Support
Do you have any of the following? (Select all that apply)*

IEP (Individual Education Plan)504 PlanDiagnosed learning difference or disabilityMedical condition requiring accommodationNone of the abovePrefer not to disclose at this time
Do you have any physical limitations that would prevent you from participating in the program or working as a massage therapist?*

NoYesI'm not sure and would like to discuss further
If you selected "Yes" above, please explain which standards you would need accommodation for and how we might assist you:
Please indicate if you would like more information about applying for accommodations:

I would like more information about applying for accommodations.
How did you find out about the Living Essence Massage Therapy Program?*

FriendInternet SearchFacebookInstagramLinkedInOther
Please upload your high school diploma (or GED/HSE), official school transcript(s), and a government-issued ID.
File Upload

Cancelof
I hereby state that the information provided in this application is truthful, and I understand that providing false information can result in dismissal from the program or denial of admission. When you press the submit button, you will receive an email confirmation that your application was received.
Signature
Living Essence Massage Institute does not discriminate on the basis of race, ethnicity, nationality, gender identity, sexual orientation, size, age, socioeconomic status, religion, ability, and cultural background. Additionally, Living Essence will reasonably accommodate students with disabilities to the extent required by applicable law and regulation.
Next Steps

Thank you for your application! The Living Essence Massage Institute Admissions Team will be reviewing your pre-application form and look forward to connecting with you soon.
Questions? Please contact us at admissions@LivingEssenceFLX.com
Should be Empty:

Pre-Application for Admission

Personal Data

Accommodations and Support

Questions? Please contact us at admissions@LivingEssenceFLX.com