Enrollment Form



A Maine Massage School

Serving the Greater Maine Area

Therapeutic Bodywork Learning Center (TBLC)

141 North Main Street, Suite 306, Brewer, ME 04412

A copy of your high school diploma, GED or college transcript must accompany this Enrollment Agreement

A $100 fee must accompany this Enrollment Agreement

Enrollment Form

About

Name

First

Last

Nickname preferred

Preferred Pronouns

Address

City

State/Province

Zip/Postal

Country

Home Phone

Work Phone

Cell Phone

Date of Birth

Social Security Number for Massage License Identification

Statement of Receipt

I ______________ certify that I received my personal interview explaining the TBLC training program on

Date

Initials

Intended Program of Study:

500 Hour Diploma Program

Enrollment Fee: $100.00 (due with this enrollment form)

_Tuition total: $ 6,500.00 intended payment schedule:(in advance $6500.00, quarterly $1625.00, monthly $520.00, twice monthly $260.00)_Tuition total: $ 6,500.00 intended payment schedule:(in advance $6500.00, quarterly $1625.00, monthly $520.00, twice monthly $260.00)

Copying fee $100 due by August 31st

Tuition Deposit: $200. If the entire program is completed, the deposit goes towards the last tuition payment. This deposit will not be refunded once the first class has started.

Additional Fees

Massage Table ($375. and up

CPR/ First Aid (Free to $70

Supplies (notebooks, pens/pencils, colored pencils, massage lotions, linens, holster, apron, masks

Class Starting DateClass Starting Date

Previous study in Massage or healthcare?

Yes

Policies

Please leave a check mark on each section signifying that you understand TBLC school policies.

Enrollment Acceptance Policy: You need to be 18 years of age or older. You must show proof of a high school diploma or GED. Submit the Application before this Enrollment Agreement. You must be willing to accept all policies of The Therapeutic Bodywork Learning Center (TBLC) . In order for this agreement to become valid, it must be completed in its entirety & accepted by TBLC.

Occupational Training: This program is intended for the field of Massage Therapy only. TBLC will not be held responsible for students not meeting their state and local requirements if for another state other than Maine.

Student Insurance: Each student is required to carry an individual student or professional liability insurance thru the AMTA while in the program (TBLC will enroll you). Information will be provided to you on AMTA student liability insurance. Upon activation, a copy of your policy must be given to TBLC.

Student Conduct / Hygiene policy: Students who show a pattern of absences, violate TBLC’s policies, interfere with other students learning, are boisterous, obscene, or in any other way conduct themselves in an unprofessional manner, are subject to an immediate dismissal. Students must be clean and tidy, free of strong scents and dressed in a modest, professional manner while at school and while participating in public clinic events.

Student Attendance: Students must attend all class hours to graduate. The program does provide a “Make up Hours Policy” and actual make up hours for the student to achieve their goal. However, students missing hours may have an extra hourly make up fee if hours cannot be made up by attending allotted times.

Individual Success: Your success or satisfaction is not guaranteed & is dependent upon your individual efforts to the requirements of the program. All efforts will be made by our TBLC staff to encourage and support you, to help you succeed.

Transfer of Credit: Transfer of credits to The Therapeutic Bodywork Learning Center are considered on an individual basis. Courses must be in line with TBLC curriculum and from an accredited college or massage school. TBLC makes no guarantee of credit transfer from our school to any other institution.

Failure to pay: Failure to pay any amount due in accordance with this agreement subjects you to be in default and liable for immediate probation / dismissal. All evaluations and records may be withheld from you until completion of your program and full payment of your tuition

Cancellations & Refund Policy:

If notification of cancellation of this Enrollment Agreement is given by the student to TBLC within 3 days of signing, the $100 Enrollment Registration fee, and $200 Deposit, if paid will be refunded.

If TBLC is notified of cancellation after the 3 day period in which the Agreement was signed, a tuition refund will be calculated and given according to any fraction of the program paid for but not completed minus the Application fee ($25 ) and Enrollment fee ($100.).

In such an event that TBLC suddenly terminates the program due to unforeseen circumstances, and the student does not wish to utilize completed credit hours in any form, s/he is entitled to a full tuition refund of only those payments actually made, including the ($100.) Enrollment fee made. No records, etc. will be given to that student.

Any dismissed student will receive a tuition refund calculated according to any fraction of the program paid for but not completed at the time of dismissal, minus the ($25.) Application fee, ($100.) Enrollment fee, and the ($200.) Deposit Fee.

All refunds will made within 30 days of the effective date.

Upload A copy of your high school diploma, GED or college transcript

Maximum file size: 134.22MB

Please read this agreement carefully before signing. Your signature below indicates that you have read and understand the catalogue/website and all the policies listed on this Enrollment Agreement form and wish to enroll in this TBLC program.

Signature:

Clear

Date

If you are human, leave this field blank.

PLEASE SEND YOUR ENROLLMENT FORM PLUS FEEs TO:

Suzanne Philp
195 Downing Road
Exeter Maine
04435

Checks may be made out to Therapeutic Bodywork Learning Center Debit, credit, Facebook pay and Venmo may also be accepted