Lighthouse Healing Arts School Application

Please fill out all required information below to begin enrollment in our massage therapy certification program.

Full Name*

Date of Birth*

Email*

Phone*

High School/GED Name & Date of Graduation*

Do you have any physical limitations?*

Do you have any prior massage therapy experience? (if yes, please explain)*

What are your career goals?*

Is there anything else you want us to know?*

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Lighthouse Healing Arts School

2032 Scherer Ave.

Laramie, WY 82070

(307) 760-2444

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