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Sage School of Massage

Training in Therapeutic Massage, Bodywork & Movement

Dream it....Learn it...Live it!

School of Therapeutic Massage, Bodywork, & Movement
* (formerly Bear Mountain, same great programs & instructors)

Contact Information

Thank you for your interest in Sage School of Massage.
Please enter your contact information and your question or comment and we'll get back to you as soon as possible. Fields with an * are required.
Please use this form to ask general questions about our school, student services for the public, community classes, and professional continuing education. When you click "submit", you will be taken back to our home page. If you are applying to the school, this form is not part of your application. Please scroll down and use the "Official School Application" form below.
THANK YOU!

To schedule a massage with Sheryl please call
970-407-8200.
Visit Sheryl's massage practice website breatheinandout.com
for more information about her practice.

Thank You!

First Name: *
Last Name: *
Main Phone: *
City: *
State: *
Email: *
Question or Comment: *

Official Sage School of Massage Application

If you would like to apply online, please fill in the
application below.  Thank You!
Only prospective students that want to apply now should use this form or request an email apllication.

First Name: *
Last Name: *
Address Street 1: *
Address Street 2:
City: *
State: *
Zip Code: *	(5 digits)
Main Phone Number: *	(area code)
Alternate Phone Number: *	(area code)
Email: *
Date of birth dd/mm/yyyy: *
How did you hear about us?: *
Emergency Contact Information Please list the name, phone number, and relationship of someone local whom we may call in the event of a medical emergency: *
Program & Schedule
Which program are you applying for?: *
Enrollment Plan and Schedule: *
Your History
Employment Please list all employment for the past 5 years. Paid and unpaid and in or out of the home: *
Education Please list all degrees, certifications, and designations earned with the year of achievement and specific areas of study: *
State your highest level of education: *
Massage, Fitness and Health Please describe your life experiences that include professional massage, fitness and health. Include how those experiences have contributed to your choice to study massage therapy: *
Personal References: Friends or Family Please include contact information about individuals who have knowledge of your desire to study massage. Your references will be contacted and asked questions relating to your interests and abilities as they relate to your success in school and as a professional massage therapist. Be sure to get permission to include them and inform them we will be in contact. Their answers will have a large impact on your application.
Personal Reference 1 Name Relationship Main Phone # Address Email How long have you known this person?: *
Personal Reference 2 Name Relationship Main Phone # Address Email How long have you known this person?: *
Professional References: Teachers or Employers Please include contact information about individuals who have knowledge of your professional abilities and education. Be sure to inform them you are applying to massage school.
Professional Reference 1 Name Relationship Main Phone # Address Email How long have you known this person?: *
Professional Reference 2 Name Relationship Main Phone # Address Email How long have you known this person?: *
Short Answer Please answer the following questions. Here's a big hint, take these questions seriously and answer them truthfully, in detail, using proper grammar and clear idea organization. Be sure to include references to the qualities you posses you believe will make you successful as a student and as a practitioner. You will be evaluated on your answers, so please give your best effort in your responses.
Please explain your choice of program and explain why you want to study it: *
What attracts you to massage as a profession? Describe why massage therapy is the next perfect step for you: *
Describe your strengths and weaknesses with regard to your past learning experiences and study habits. Include reference to any learning disabilities if applicable past and present: *
Describe your strengths and weaknesses with regard to self directed activities and your level of inner motivation: *
Describe your philosophy of wellness and the healing process: *
Give a brief description of your personal support system: *
What changes in your life might you need to make to ensure your success in this program of study: *
What activities do you do to take care of yourself and how regularly? Name and explain at least 3: *
Personal & Confidential Student Information Answers of yes or not sure do not ensure an automatic rejection of your application. However, any untrue answers will automatically deny your acceptance to any program. For state massage registration you are required to have a background check and be a US citizen. The director may request you have the background check a done as part of your application at your expense. Information entered on this form is encrypted for your protection and we respect your privacy.
Have you ever been convicted of a felony or arrested for a violent, fraudulent, or sexual offense? If yes, explain in detail: *
Do you have any medical, physical, or psychological conditions which may require special adaptation for your performing and receiving massage techniques? If yes or not sure please explain. Please include physical and sexual abuse history even if you feel fine about it now and any issues you are aware of about how you feel about being touched in general. *
Please list all current health conditions, medications, and supplements taken on a regular basis: *
Please list all allergies: internal, topical and environmental sensitivities: *
If you ever been treated for substance abuse? If yes, please explain the circumstances and your sobriety experience: *
Have you ever been rejected or dismissed from any school or program of study? If yes please explain: *
Please check the box for an answer of "yes" to the following questions
	Are you a US citizen?
	Have you read the prerequisites on the Policies and Procedures page and do you meet or exceed the minimum prerequisites?
	Are you at least 18 years of age?
	Can you read, write and comprehend the English language?
I certify that all the information I have included in this application is true and complete. By typing my name in the box below as my e-signature, I authorize the school administrators to investigate any or all of the statements made by me in this document and give permission for this information to be disclosed to them for the purposes of this application and determining my admissions status. I also understand that making any false statements is grounds for my disqualification from consideration for enrollment in any program now and in the future or for immediate dismissal from the program if it has already commenced. I further authorize the school and its administrators permission to share information on my performance and grades to the person who is financially responsible for my tuition if other than myself. I understand the nature of this program is that of an apprenticeship with small classes possibly with only me as a student and includes some independent study. I understand that the school can offer no financial aid except for the payment plans and is not accredited to accept federal grants and loans or VA assistance at this time. If the applicant is under 18 the signature of the parent or legal guardian will be will be required for the enrollment agreement. This e-signature complies with the disclosure and acceptance of responsibilities within this document and the online catalog.
	I have read the paragraph on the online application.
Please type your name here to electronically sign this application: *
Todays Date dd/mm/yyyy: *