Myotherapy Institute Application for Admission

Please ensure the information on this application and all application materials are accurate to the best of your knowledge. Once you have submitted the application, you will have the option to submit your application fee online. Please refer to the Admission Procedures page for the additional steps in the application process.

Blended Programs *

AAS Degree in Massage Therapy

1000-Hour Diploma

Enrollment Start Date *

August

January

Biographical Information

Last Name *

First Name *

Middle Name *

Birth Date *

Gender *

Male

Female

Contact Information

Address *

City *

State *

Zip *

Cell Phone *

2nd Phone

Email *

Emergency Contact Information

Name *

Cell Phone *

Relationship *

Other Information

Ethnic Background *

(Required for U.S. Government compliance with 1964 Civil Rights Act) Please select one or more which applies to you.)

Have you been convicted of a felony or misdemeanor? *

Yes

Financial Aid *

	Yes	No
Do you have a scholarship? *	Do you have a scholarship? - Yes	Do you have a scholarship? - No
Are you applying for Federal Financial Aid? *	Are you applying for Federal Financial Aid? - Yes	Are you applying for Federal Financial Aid? - No
Are you applying for Vocational Rehabilitation? *	Are you applying for Vocational Rehabilitation? - Yes	Are you applying for Vocational Rehabilitation? - No

Do you have a physical, learning or psychiatric disability? *

Yes

Explain

Verification *

By clicking here, you are indicating the information on this application and all application materials are accurate to the best of your knowledge.

Contact

Myotherapy Institute - Lincoln
245 S 84th St #100
Lincoln, NE 68510
provost@myotherapy.edu

Admissions
402.421.7410 (9AM - 2PM)
admissions@myotherapy.edu

Financial Aid
402.421.7410 (9AM - 2PM)
financialaid@myotherapy.edu

Myotherapy Institute Application for Admission

Myotherapy Institute Application for Admission

Contact

Massage Programs

Prospective Students

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