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Present State of Health
Do you have any health-related problems that may interfere with massage?
No
Yes
If yes, please explain:
Do you have any or have you had any communicable diseases in the past 2 years?
No
Yes
If yes, please explain:
Have you ever been convicted of a felony or misdemeanor, other than traffic violations?
No
Yes
If yes, please explain:
Emergency Contact: (Name, address, phone)
Previous Education
Name of High School
City/State
Year Graduated
If you are NOT a high school graduate, have you completed the GED requirement?
No
Yes
Date received:
College:
Major
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Date Graduated
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Vocational Training
Program Information
Program Choice: Massage Therapy Diploma
Payment Option:
Payment in full upon enrollment
Payment plan
Essay Questions
Why are you interested in becoming a massage therapist?
What strengths and resources do you bring to this training?
Do you have experience in any type of massage? If so, please explain.
Have you ever surrendered a professional or occupational license, registration or certificate? If yes, please explain.
Describe your experience with massage therapy and its effect on your life.
I hereby state that all of the information on this application is correct to the best of my knowledge.
(Type your full name in the box).
Date: 02-22-2012
Refund Policy
570IAC 1-8-6.5 Resident institutions; refunds Sec. 6.5
(a) The postsecondary proprietary educational institution shall pay a refund to the student in the amount calculated under the refund policy specified in this section or as otherwise approved by the commission. The institution must make the proper refund no later than thirty-one (31) days of the student's request for cancellation or withdrawal.
(b) The following refund policy applies to each resident postsecondary propriety educational institution, except as noted in section 4.5 of this rule:
(1) A student is entitled to a full refund if one (1) or more of the following criteria are met:
(A) The student cancels the enrollment agreement or enrollment application within six (6) business days after signing.
(B) The student does not meet the postsecondary proprietary educational institution's minimum admission requirements.
(C) The student's enrollment was procured as a result of misrepresentation in the written materials utilized by the postsecondary proprietary educational institution.
(D) If the student has not visited the postsecondary proprietary educational institution prior to enrollment and, upon touring the institution or attending the regularly scheduled orientation/classes, the student withdrew from the program within three (3) days.
(2) A student withdrawing from an instructional program, after starting the instructional program at a postsecondary proprietary institution and attending
one (1) week or less, is entitled to a refund of 90% of the cost of the financial obligation, less an application/enrollment fee of ten percent (10%) of the total tuition, not to exceed one hundred dollars ($100.00).
(3) A student withdrawing from an instructional program, after attending more than one (1) week but equal to or less than twenty-five percent (25%) of the duration of the instructional program, is entitled to a refund of seventy-five percent (75%) of the cost of the financial obligation, less an application/enrollment fee of ten percent (10%) of the total tuition, not to exceed one hundred dollars ($100.00).
(4) A student withdrawing from an instructional program, after attending more than twenty-five percent (25%) but equal to or less than fifty percent (50%) of the duration of the instructional program, is entitled to a refund of fifty percent (50%) of the cost of the financial obligation, less an application/enrollment fee of ten percent (10%) of the total tuition, not to exceed one hundred dollars ($100.00).
(5) A student withdrawing from an instructional program, after attending more than fifty percent (50%) but equal to or less than sixty percent (60%) of the duration of the instructional program, is entitled to a refund of forty percent (40%) of the cost of the financial obligation, less an application/ enrollment fee of ten percent (10%) of the total tuition, not to exceed one hundred dollars ($100.00).
(6) A student withdrawing from an institutional program, after attending more than sixty (60%) of the duration of the instructional program, is not entitled to a refund.
This is the refund policy of the Indiana Commission on Proprietary Education for programs greater than 120 clock hours in length.
Verification Sequence:
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Contact Charter
Call now to enroll: 1-866-766-3660
Email: info@chartermassage.org
714 E Winona Avenue
Warsaw, IN 46580
