PMTI Applicant Personal Reference Form

PMTI Applicant
Personal Reference Form

Applicant's Name: *

This applicant has applied to study massage therapy in PMTI's Professional Training Program. We would appreciate your thoughtful assessment of this applicant's potential to succeed in the program.

Thank you!

Your Name: *

Street Address *

Address Line 2

City *

State *

Zip Code *

Phone Number *

Email Address *

1. How long have you known this person? *

2. In what capacity do you know this person? (friend, client, colleague, neighbor, etc.) *

3. What experience, if any, have you had with massage? *

4. How would you rate this applicant's integrity and dependability? *

5. Does he or she get along well with other people? *

6. How would you describe this applicant's communication skills? *

7. How would you describe this applicant's academic skills? *

8. Please state any reasons why PMTI should or should not accept this person into the three-term Professional Training Program. *

Additional Comments: