Student Interest Form for Massage Journey Academy

Student Interest Form

Share your goals and learn about the next steps to start your massage therapy journey.
Basic Information
First Name

First NameLast Name
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Email Address
example@example.com
Home Address

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Date of Birth

MonthDayYear
Date
Eligibility Questions
Are you at least 18 years of age or older?
Do you currently live in Texas?
Have you ever been convicted of or pleaded guilty/no contest to a criminal offense?
Massage therapy licensure in the state of Texas is regulated by the Texas Department of Licensing and Regulation (TDLR). If you have a criminal history or background concerns, it is your responsibility to contact TDLR directly prior to enrollment to discuss your eligibility for massage therapy licensure. Massage Journey Academy cannot determine licensing eligibility on behalf of the state.
Interest & Goals
What best describes your interest in massage therapy?
What interests you most about becoming a massage therapist?
Logistics
How did you hear about Massage Journey Academy?
Preferred payment option (optional)
Next Steps Agreement
Submitting this form is only an inquiry and does not guarantee enrollment into Massage Journey Academy. Additional onboarding steps, handbook review, acknowledgment forms, and enrollment requirements must be completed before starting the program.
I understand and agree.
Should be Empty:

Student Interest Form