Application for Admission

Contact Information
Required **

Massage and/or Health Profession Experience and Education

Educational Background:

Employment History:

Please begin with most recent.


Required **

**Please indicate which class you would like to join:  
A.R.E. Member ?   YES NO
How do you plan to fund your massage education?  
Are you a citizen of the United States?   YES NO
IF NO, Please list your country of origin  
Have you ever been convicted of a felony or misdemeanor other than traffic offenses?
If yes, please explain:

Additional Admissions Requirements:

  1. Non-refundable application fee of $75.00
  2. Proof of high school graduation or equivalency (school transcripts, diploma or GED copy)
  3. Documentation of TB test within last 12 months (obtainable from personal physician or health clinic/urgent care)
  4. Personal Interview with staff or faculty member

Payment of Application Fee

Required **

  Application Fee $75.00 **
Credit Card Information:  
** Name on the Credit Card:  
** Credit Card Type:  
** Card Number:  
** Expiration Date:    
By submitting this form, you are certifying that the information given in this application
is correct to the best of your knowledge.

By submitting this form, you are agreeing to our collection, storage, use, and disclosure of your personal info in accordance with our privacy policy.

Cayce/Reilly® School of Massage | 757-457-7270
215 67th Street, Virginia Beach, VA 23451 |