|
HOLISTIC HORIZONS INSTITUTE OF HEALING ARTS |
|
Application |
|
HOLISTIC HORIZONS
Application Process
Application fee: $47.00 non refundable. (Sent with the following:)
Application form completed.
Essay completed (5 pages typed and double spaced).
Three (3) letters of reference (non-relative). (Must be sent directly to Holistic Horizons from reference.)
Transcripts from all schools attended. (Must be official and sent directly from the school or college. A minimum GPA of 2.5 is required for consideration for enrollment at Holistic Horizons. If your GPA is below 2.5 but above 2.0 you may be eligible for enrollment under certain circumstances. Below 2.0 will not be accepted.)
You must be a high school graduate or equivalent to apply. (GED must give a GPA; seniors may apply before graduation.)
You must be 18 years or older to enroll. (enrollment in modules 1 & 5)
All the above items must be received by Holistic Horizons by 60 days prior to the module to be considered for enrollment. Late applications may not be accepted and may require an additional late fee.
Individual interview(s) will be set up after all the above information is received and reviewed. (Tours of the school will be given at the interview.)
After the interview you will have to submit a copy of your physical examination.
You will be notified by mail as to whether you are accepted as a student. Please allow 30 days to process the application.
Rhonda Reif Moore, MBA, LMT HOLISTIC HORIZONS
Telephone:(319)752-0175
Application for enrollment into HOLISTIC HORIZONS program. Please fill out all questions completely. Incomplete forms will not be eligible for consideration. Application Fee -- $47.00 (non-refundable) NAME____________________________________________________________________________ LAST FIRST MIDDLE MAIDEN
CURRENT ADDRESS___________________________________________________________________
_________________________________________________________________________________
PREVIOUS ADDRESS___________________________________________________________________
_________________________________________________________________________________
SEX: Female Male MARITAL STATUS: Single Married Divorced
SOCIAL SECURITY NUMBER________-________-__________
BIRTHDATE______________________ AGE__________
CURRENT OCCUPATION_________________________________YEARS THERE?__________
PREVIOUS OCCUPATION__________________________________YEARS THERE?_________
HOME PHONE___________________WORK PHONE________________________ CELL-PHONE:__________________________EMAIL:______________________________
HIGH SCHOOL GRADUATE? Yes No GED GPA________________
WHERE?_____________________________________________________________________________
LAST LEVEL OF EDUCATION COMPLETED: High School : 10 11 12 College: 1 2 3 4 Graduate School
OTHER___________________________________________________________________________ WHERE?______________________________________________________________________________ (Must have official transcript sent directly to HOLISTIC HORIZONS.)
HOW DID YOU HEAR ABOUT US?__________________________________________
_________________________________________________________________________________
LIST ANY PHYSICAL OR MENTAL DISABILITIES HOLISTIC HORIZONS SHOULD BE AWARE OF:_______________________________________________________________ _________________________________________________________________________________(ABMP requires that each applicant must have a physical.)
DO YOU FEEL THIS DISABILITY WILL INHIBIT YOUR ABILITY TO PERFORM THE DUTIES REQUIRED OF A LICENSED MASSAGE THERAPIST? _____________________________________
DO YOU HAVE ANY PREVIOUS MASSAGE THERAPY EXPERIENCE?_______________________WHEN?______________________ WHERE_______________________ WHAT DOES THE WORD “HOLISTIC” MEAN TO YOU?_______________________________ _________________________________________________________________________________ PLEASE WRITE A FIVE (5) PAGE ESSAY ON A SEPARATE PIECE OF PAPER EXPLAINING WHY YOU DESIRE TO BECOME A LICENSED MASSAGE THERAPIST, AND WHY YOU HAVE CHOSEN HOLISTIC HORIZONS AS YOU SCHOOL OF CHOICE. (Please attach it to this paper—typed and double spaced.)
MASSAGE THERAPISTS MUST SUBSCRIBE TO A HIGH STANDARD OF PERSONAL AND PROFESSIONAL ETHICS AND STANDARDS!
HAVE YOU EVER BEEN CONVICTED OR CHARGED WITH A CRIME? Yes No IF YES, EXPLAIN______________________________________________________________________
________________________________________________________________________________
HAVE YOU EVER BEEN EMPLOYED IN A JOB OR OCCUPATION WHICH WOULD CONFLICT WITH THE PERSONAL IMAGE A MASSAGE THERAPIST MUST ADHERE TO? (Such as Strip Bars, Novelty Establishments, Escort Services, Etc.) Yes No
IF YES, EXPLAIN_________________________________________________________________
BY SIGNING BELOW, I GIVE MY PERMISSION AND CONSENT FOR HOLISTIC HORIZONS TO VERIFY ANY AND ALL INFORMATION INCLUDED ON THIS APPLICATION. I REALIZE THAT THIS MAY INCLUDE A BACKGROUND CHECK, POLICE RECORDS, ETC. I ALSO REALIZE THAT GIVING ANY FALSE INFORMATION WILL RESULT IN IMMEDIATE TERMINATION FROM THE PROGRAM, SHOULD I BE ACCEPTED, AND THAT NO REFUNDS WILL BE GIVEN. I ALSO AGREE THAT SHOULD I BE CHARGED OR CONVICTED OF A CRIME OR ENGAGE IN UNETHICAL BEHAVIOR, I MAY BE TERMINATED FROM THE PROGRAM. I ALSO UNDERSTAND THAT UNETHICAL, UNPROFESSIONAL, DISRUPTIVE, OR INAPPROPRIATE BEHAVOIR, OR VIOLATION OF SCHOOL POLICIES AND PROCEDURES OR FAILURE TO MAINTAIN A 70% GRADE OR HIGHER WILL RESULT IN TERMINATION FROM THE PROGRAM, WITHOUT A REFUND. ________________________________________ ________________________________ SIGNED DATE
DEPOSIT RECEIVED_______________________ CHECK NO.____________________
HOLISTIC HORIZONS INSTITUTE OF THE HEALING ARTS (319) 752-0175
Letter of Reference for Student Applicants
____________________________________________(Student’s name);
is applying for enrollment at Holistic Horizons, Institute of the Healing Arts. Your assistance is appreciated. Please mail responses directly back to Holistic Horizons. Your comments will be kept confidential. Forms given to students by the reference will not be accepted and could delay the application process.
Please write a letter of reference and enclose it with this form.
Please comment on all of the following areas in your letter and then add anything additional that you would like to state about the applicant.
Integrity Ethical Behavior Sense of Responsibility Ability to Relate to Others Academic Readiness Ability to Manage Time Emotional Stability Maturity Level Willingness to Follow Policies and Procedures Level of Commitment to Projects
Your Name (reference)___________________________________________________________________
Address___________________________________________________________________________ Occupation __________________________________________________________________ Phone (Home)_______________________________(Work)________________________________ How long have you known this applicant?____________________________________________________
In what capacity have you known the applicant?_______________________________________________
(Note to Prospective Student—Make 3 copies and give to 3 references)
HOLISTIC HORIZONS INSTITUTE OF THE HEALING ARTS (319) 752-0175 Please submit an essay on why you want to pursue a career in massage therapy/bodywork/healing arts. The essay must be five (5) pages, typed and double-spaced, with 12-point font and standard margins. Include a cover page and title page.
Have a copy of your physical sent to Holistic Horizons directly from the physician’s office. It must state you are able to give and receive bodywork.
Please have all transcripts from the school(s) you have attended, including college coursework, sent directly to Holistic Horizons from the school/college you were enrolled at.
You must have a GPA of 2.5 or higher to be accepted in the program. Special arrangements can be made for those students who fall between 2.5 and 2.0. If your GPA is below 2.0, you cannot be accepted in the program. (This is because the state requires a minimum grade of 70% to become licensed. A GPA lower than a 2.0 does not meet this requirement.)
Please enclose a non-refundable application fee of $47.00 with the application packet.
HOLISTIC HORIZONS
Classes are offered through SCC, Kirkwood and Spoon River (Call SCC for a Current Flyer on Classes being offered this Session 319-752-2731) Elective and Continuing Education Classes Offered at Holistic Horizons Price per class may vary per number of hours, location and type.
I would be interested in taking the following classes in Holistic Healing: (Please circle all that apply)
Hands, feet & face massage Infant Massage Reiki I Arms, legs & back massage Reflexology Reiki II Energy Balancing Aromatherapy (intro) Custom blending Aromatherapy Energy Clearing Space Clearing Eat Right for your Blood Type Feng Shui / 5 element theory Advanced Feng Shui Aromatherapy & Feng Shui Numbers – Energy gate locks Advanced Numbers Chakra System Astrology & Your Health Intro to CAM Colors – Therapeutic Meaning How to heal using colors Manifesting Power of Thoughts Mind and body connection Mystery class Healing with Music Retreat “A Day of Play” Retreat “At Least a Week!” Chakras and Feng Shui Guided Visualization Holistic Healing Techniques Chakra Balancing Pregnancy Massage Chakra Balancing Chakra Clearing Meaning of Gemstones Healing with Gemstones Pet massage Sound Healing Energy Testing Vitamins/herbs Nutrition Stress Management Relaxation Techniques Power of Positive Thinking Special Needs Techniques Chair Massage Hot Stone Massage Body Polishing Body Brushing Hydro-therapies Therapeutic mud Five Element Theory Acupressure Shiatsu Trigger Points Therapeutic Exercise Eastern Anatomy Staying Healthy w/ the Seasons Yoga Tai Chi Water Aerobics
Please list any other suggestions for classes that you have! Name:________________________________________ Phone:________________________________________ Occupation:____________________________________ Address:_______________________________________
|
