Therapeutic Massage Application

Therapeutic Massage Application
Please select cohort you are applying for:

July 2025 (Application Due Date May 18)January 2025 (Application Due Date November 5)
The "Submit" button will save your application and send you a link allowing you to edit and update your application until all parts of the application are complete.

IF YOU DO NOT GET A LINK TO EDIT YOUR APPLICATION, EMAIL ADVISING@BTECH.EDU

Therapeutic Massage Application
Name

First NameMiddle NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Date of Birth

MonthDayYear
Date
Email
example@example.com
Phone Number
Please enter a valid phone number.
Emergency Contact Name

First NameLast Name
Emergency Contact Phone Number
Please enter a valid phone number.
High School Graduation Date

MonthDayYear
Date
UPLOAD ACADEMIC ASSESSMENT
Upload Assessment & Learning Center score sheet or ACT/SAT score

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Submit your Assessment & Learning Center score sheet, which was provided to you upon completing your Academic Assessment. If you have already taken the Academic Assessment and need a copy of your score sheet, please email testing@btech.edu to request a copy and upload it to this application BEFORE the deadline. (If you need to take the Academic Assessment, you can email or go to btech.edu/assessment to schedule it.)
UPLOAD COLLEGE TRANSCRIPTS IF APPLICABLE

Education: List the colleges you have attended beginning with most recent. Degrees or certificates must be from an accredited college or university to be considered for application points.

	Name of School	Dates of Attendance (Start - End)	Degree (Yes or No)
1
2
3
4

If you have been awarded a degree or certificate listed above, please upload a copy of your official transcript here to be awarded a point.

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UPLOAD INDUSTRY LICENSE IF APPLICABLE
Health Care Training (Must have current certification to be awarded point)
Certified Nursing Assistant (CNA)

YesNo
Date
Medical Assistant (MA)

YesNo
Date
If “Yes,” please include a copy of your current certification with your application to be awarded a point.

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The "Submit" button will save your application and send you a link allowing you to edit and update your application until all parts of the application are complete.

IF YOU DO NOT GET A LINK TO EDIT YOUR APPLICATION, EMAIL ADVISING@BTECH.EDU

Health Care Work or Health Care Volunteer Experience

List most recent work or volunteer experience first. If none, indicate by N/A.
Agency 1
Phone Number
Please enter a valid phone number.
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Position
Supervisor
Job Description
Dates of Employment (From)
Dates of Employment (To)
Agency 2
Phone Number
Please enter a valid phone number.
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Position
Supervisor
Job Description
Dates of Employment (From)
Dates of Employment (To)
The "Submit" button will save your application and send you a link allowing you to edit and update your application until all parts of the application are complete.

IF YOU DO NOT GET A LINK TO EDIT YOUR APPLICATION, EMAIL ADVISING@BTECH.EDU

References

List the names of the two professional people who will be completing your Reference Evaluation forms. References must be people who are now or who have been your employer, supervisor, former instructor, or community leader. They must have known you for at least six months and cannot be related to you. Two reference forms are required for your application to be considered. Please make sure to inform references that they will be contacted by a representative at Bridgerland Technical College via email or text. Reference Evaluations must be submitted no later than SEVEN DAYS after cohort application deadline.
Please Note: The Family Educational Rights and Privacy Act of 1974 and its amendments guarantee student access to educational records concerning them. However, students are permitted to waive their rights to access recommendations.
REFERENCE 1
Name

First NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Company/Institution
Position
Phone Number
Please enter a valid phone number.
Email
example@example.com
REFERENCE 2
Name

First NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Company/Institution
Position
Phone Number
Please enter a valid phone number.
Email
example@example.com
The "Submit" button will save your application and send you a link allowing you to edit and update your application until all parts of the application are complete.

IF YOU DO NOT GET A LINK TO EDIT YOUR APPLICATION, EMAIL ADVISING@BTECH.EDU

Professional Goal Statement

In the space below, write a statement of your professional goals. The statement will be graded on spelling, punctuation, grammar, and sentence structure.
The statement must be a minimum of 150 words and a maximum of 200 words.

0/200
The "Submit" button will save your application and send you a link allowing you to edit and update your application until all parts of the application are complete.

IF YOU DO NOT GET A LINK TO EDIT YOUR APPLICATION, EMAIL ADVISING@BTECH.EDU

Complete the following checklist below before submitting your application. It is your responsibility to ensure that all items are completed. Please note that any missing information will render your file incomplete, and you will not be considered a possible candidate for this program.

I have complete the Bridgerland Technical College Certificate-Seeking application. If not, follow the link here.I have completed the Academic Assessment and have uploaded a copy of the Assessment & Learning Center score sheet. OR I have a composite ACT score of 17 or a composite SAT score of 930 taken no more than four years prior to enrollment and have uploaded a copy of the score.I have completed the Application Form, Reference Evaluation form and Goal Statement.I understand that in order to receive a point for completing a degree, the degree must have been awarded from an accredited college or university.I understand that I will have to complete a non-refundable background check upon acceptance into the Therapeutic Massage program.I will be 18 before the next cohort begins.I understand that applications are due May 18th for the July cohortI understand that applications are due November 5th for the January cohort
IMPORTANT! Be Sure to Read the Following:

To be a licensed massage therapist in the State of Utah, the applicant must be in conformity with the Utah Massage Therapy Practice Act. Applicants who have been convicted of a felony or any drug-related charges; have been involved as the abuser in any incident of verbal, physical, mental, or sexual abuse; or may pose a threat to themselves, clients, or the public health, safety, or welfare because of any circumstances or conditions, should determine their eligibility status with the Division of Occupational and Professional Licensing. Locate an Application for Criminal History Determination on https://dopl.utah.gov/mt/

The Division of Occupational and Professional Licensing makes the final decision on the issue of a license to practice in the State of Utah. If you have a record of convicted criminal actions, it may affect your eligibility for admission to the Therapeutic Massage program at Bridgerland Technical College. Admission to the program is contingent upon the submission of a satisfactory background check. If a background check reveals a history of convicted criminal actions, you may be expelled from the program.
I CERTIFY THAT I HAVE READ THIS STATEMENT
To complete the signing process, please type your full name in the signature box and click 'submit'.
The "Submit" button will save your application and send you a link allowing you to edit and update your application until all parts of the application are complete.

IF YOU DO NOT GET A LINK TO EDIT YOUR APPLICATION, EMAIL ADVISING@BTECH.EDU
Should be Empty:

Therapeutic Massage Application

Therapeutic Massage Application

UPLOAD ACADEMIC ASSESSMENT

UPLOAD COLLEGE TRANSCRIPTS IF APPLICABLE

UPLOAD INDUSTRY LICENSE IF APPLICABLE

Health Care Work or Health Care Volunteer Experience

References

Professional Goal Statement