American Massage Therapy Association^®

* 

Name:

* 

Address:

* 

City:

* 

State:

AL AK AR AZ CA CO CT DC DE FL GA HI IA ID IL IN KS KY LA MA MD ME MI MN MO MS MT NC ND NE NH NJ NM NV NY OH OK OR PA RI SC SD TN TX UT VA VI VT WA WI WV WY --Province-- Alberta British Columbia Manitoba New Brunswick Newfoundland and Labrador Northwest Territories Nova Scotia Nunavut Ontario Prince Edward Island Quebec Saskatchewan Yukon --US Territories-- Guam Puerto Rico Virgin Islands

* 

Country:

Canada United States

* 

Zip Code:

Work Phone:

* 

Home Phone:

Fax:

* 

E-mail:

(If you provide a current e-mail address above, we will confirm your membership via e-mail. The membership materials will arrive by mail within 7 business days.)

Dues for membership in the American Massage Therapy Association may be deducted by members as ordinary and necessary business expense. Under current tax regulations, 5% of your dues is not deductible because of AMTA’s lobbying activity. Massage Therapy Journal subscription price for one year ($25 U.S.) is included and may not be deducted from dues.

Your membership includes a Professional and General Liability Insurance Policy backing you with $6,000,000 aggregate coverage per year and up to $2,000,000 per single occurrence. You are provided with liability insurance coverage for school-sponsored and sanctioned activities while a student and professional coverage after graduation if you qualify.

Student Membership

*  $79 +    $ (chapter fee) =  $

*    I am currently enrolled in a 500 in-class hour minimum entry-level massage therapy training program.
 

* 

School Name:

* 

Address:

* 

City:

* 

State:

AL AK AR AZ CA CO CT DC DE FL GA HI IA ID IL IN KS KY LA MA MD ME MI MN MO MS MT NC ND NE NH NJ NM NV NY OH OK OR PA RI SC SD TN TX UT VA VI VT WA WI WV WY

* 

Zip Code:

* 

Total Program Hours:

* 

Anticipated Graduation Date(mm/dd/yyyy):

 
Your application and payment must be received at the AMTA National Office prior to your graduation date to qualify for this special $79 offer.

Code of Ethics
By agreeing to these terms, I represent that I meet the qualifications for Professional Membership in the American Massage Therapy Association and I have provided documentation of my qualifications to the AMTA. I agree to abide by AMTA's Bylaws and Code of Ethics upon acceptance of my membership. I understand that violation of the AMTA Bylaws or Code of Ethics may be grounds for termination of my membership. I further represent as follows:
1. If I in a state which requires a license to practice massage therapy, I have such a current, valid license.
2. If I practice in a state which does not require a license to practice massage therapy, I have met all other state and/or local regulations, qualifications and requirements for practice in the state and/or locality in which I practice.

I have read the foregoing, and I represent that, to the best of my knowledge and belief, the above information is complete and accurate. I understand that if I have not answered fully and truthfully, I may be subject to disciplinary action up to and including termination of my membership in AMTA.

*  I have read the above and agree to these terms

* Date: 

Opt-out Options (Your response is required for AMTA to meet federal guidelines.)

* You may use my name for rental mailing lists

Yes No

* I wish to receive e-mails from AMTA

Yes No

Payment Options

 Promotional Code

 Promotion Applied

* Card Type:

MasterCard  Visa  Discover  American Express

* Card Number:

* Card Security Code:

What is this?

* Exp. Date: 

01 02 03 04 05 06 07 08 09 10 11 12/

* Cardholder's Name: