Bodywork + Healing Arts Massage Therapy Program

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Panacea Holistic Institute

555 Hour Bodywork + Healing Arts Program

Thank you for connecting with Panacea. We are honored to be part of your growth!

Our Admissions Process:

Start your new life !

Name*

Pronouns*

They, Them, Theirs
She, Her, Hers
He, Him, His

Email*

Phone Number*

Address*

Date of Birth*

Current Website/ Instagram Handle / Social Media Accounts:*

Emergency Contact*

Emergency Contact Phone Number*

Allergies & Other Important Medical Info*

Are you happy to share your contact information with class peers?*

Who can we thank for referring you to this program?*

Instagram
Facebook
other social media
flyer
friend/coworker
Instructor
other
CAMTC

Preferred Start Date:

Sep 2023 - Day School

m-w // 10-2:30 pm

Jan 2024 - Night School

m-w // 5-9:10 pm

Jan 2024 -Day School

Spring 2024 - Day School

Jan 2024 - Weekend School

Spring 2024 - Night School

Spring 2024 - Day School

Educational Information

I have graduated from high school or the equivalent.

I am fluent in English or am willing to hire a professional translator to assist me throughout the CMT program.

I have taken a Panacea course in the past*

Have you ever been convicted of a felony?*

Have you ever been convicted of a misdemeanor?*

Were any of these convictions Expunged?*

Disclaimer: In the state of California, a massage therapist is unable to obtain a license if s/he has been convicted of a felony. A misdemeanor may also preclude licensure.

Financial Assistance Programs

Are you interested in partial work-trade?

Identity Verification

Please upload current Drive License or other Government ID*

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Verification*

I understand the above disclaimer and confirm that all of the above is true and correct.

I have read and agree to the terms above.

How did you hear about this course?*

Is there anything else you would like to share with us?

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