Massage Therapy Application

Thank you for your interest in the Massage Therapy program at Community College of Philadelphia. Please complete the form below to apply. Seating availability is limited in this program. You will be notified within three business days regarding confirmation of your status in the program. If this program reaches capacity, you will be included on the waitlist.

Date of Birth *
Are you a U.S. Citizen? *

If yes, how long?

If no, what is your visa status? *
Are you a resident of Pennsylvania? *

If yes, how long?

Are you a resident of Philadelphia? *

If yes, how long?

Statistical information (Optional):

The following information is requested on a voluntary basis for statistical purposes only. It will be kept confidential.

Gender
Ethnic Background
Choose the class you want to register for: *
Payment Options

Community College of Philadelphia offers many flexible payment options tailored to your needs. Payment must be made in full in order to confirm your seat in this program. Please indicate your preferred payment method below and a staff member will contact you with more information:

Select Payment Option *
Declaration *
Date *