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Out of Province Membership Application

Please list your home address and the business addresses of any clinics that you practice in. Also indicate which address you wish all mail to be sent to.

    Your Name:
    Home Address:
    Town/City:
    Province:
    Postal Code:
    Phone:
    Email:

     

    Primary Workplace Name:
    Business Address:
    Town/City:
    Province:
    Postal Code:
    Business Phone:
    Business Fax:

     

    Do you have a secondary/additional work place?
    Secondary Workplace Name:
    Business Address:
    Town/City:
    Province:
    Postal Code:
    Business Phone:
    Business Fax:

     

    Education:

    Post Secondary

    Massage Therapy School Attended
    School Name:
    Address:
    Phone:
    Date of Graduation:

    Registration with: College of Massage Therapists'

    Are you now or have you in the past been associated with any other governing body that regulates massage therapy?

    If yes, specify:


    Additional pre/ post graduate skills/ training

    I agree to abide by the Constitution, Bylaws, Code of Ethics and Policies of the Newfoundland & Labrador Massage Therapists’ Association (NLMTA). I verify that all statements contained in this application are accurate and I give my permission to the NLMTA to contact any school, association or college with which I have been involved to verify any information given. Please sign the field below:

    Signature:


    Date:

    According to NLMTA Bylaws, prospective members must successfully complete the CMTNL examination and be a member of this regulatory body. Exemptions will be made when the applicant is in good standing with the College of Massage Therapists’ in Ontario or B.C. or New Brunswick. The NLMTA membership year is from October 1 to September 30. Membership fees include mandatory professional liability insurance and membership in the Canadian Massage Therapy Alliance. When membership requirements are met, you will be sent a New Membership package.

    All payment information and options, as well as the ability to complete payment, will be provided to you on submission.