Professional Member Application Form - $235 + Chapter Fee                        Printable application

We’re delighted to have you join us as an AMTA Professional member!

You're entitled to all benefits described on our Benefits of Professional Membership page.

* Indicates required field

* 

Name:

* 

Address:

* 

City:

* 

State/Province:

* 

Country:

* 

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 US) 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.

*  $235 +    $ (chapter fee) =  $


Professional Membership Criteria
Please check and submit documentation for one of the following:

Photocopy of diploma or proof of graduation from any one minimum 500 in-class hour entry-level massage therapy training program. (If diploma does not indicate hours or location, processing might be delayed)

Photocopy of current AMTA-accepted city, state, or provincial license* from any of the following: AL, AR (1988 issue or later), AZ, CT, DC, DE, FL, GA, HI, IA, IL, KY, LA, MD, ME, MO, MS, NC, ND, NE, NH, NM, NY, NV, OH, OR, RI, SC, SD, TN, UT, VA, WA, WI, WV; or the Province of Ontario, Canada

Photocopy of National Certification Board for Therapeutic Massage and Bodywork (NCBTMB) certificate or confirmation of passing score

* Must have completed minimum 500-hour requirement for education, regardless of licensing method.

NOTE!  Fax one of the above documents to 847-864-5196 or mail to: AMTA Member Services, 500 Davis St., Suite 900, Evanston, IL 60201-4695 within 24 hours of submitting this form online. Membership cannot be processed without this documentation. Delay in sending this document will delay your processing time. If you have any problems please call us toll-free at 877-905-2700.

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

Mailing Lists:  You may use my address for rental mailing lists.

Yes No

E-mails:  I wish to receive e-mails from AMTA.

Yes No
I'd like to receive my Hands On® newsletter by Mail Email

Payment Options

* Card Type:

MasterCard  Visa  Discover (Select One)

* Card Number:

* Exp. Date: 

/

* Cardholder's Name:

NOTE: When submitting your order, please press the Submit button only once to avoid duplicating your submission. During high volume times, your order may take a little extra time to process. AMTA is not responsible for fees resulting from bounced checks, stop-payments, overdrawn accounts or exceeded credit limits. Dues are nonrefundable.
If you have any problems please contact info@amtamassage.org