First Name*

Last Name*

Email*

SSN (Last 4 digits)*

Graduation Year*
—Please choose an option—2014201320122011201020092008200720062005200420032002200120001999199819971996199519941993before 1993

Are you presently working as a massage therapist?
YesNo

I work as a/an
Independent ContractorPrivate Practitioner - Self-employedPart-Time EmployeeFull-Time Employee

Business Name

Address

Phone

Contact Name

Start Date

Number of days worked per week

Your Job Title

Pay Terms
HourlyPer massageCommission PercentageSalaried

Business Name

Address

Phone

Contact Name

Start Date

Number of days worked per week

Your Job Title

Pay Terms
HourlyPer massageCommission PercentageSalaried

I work as a/an
Independent ContractorPrivate Practitioner - Self-employedPart-Time EmployeeFull-Time Employee

Business Name

Address

Phone

Contact Name

Start Date

Number of days worked per week

Your Job Title

Pay Terms
HourlyPer massageCommission PercentageSalaried

I work as a/an
Independent ContractorPrivate Practitioner - Self-employedPart-Time EmployeeFull-Time Employee

Business Name

Address

Phone

Contact Name

Start Date

Number of days worked per week

Your Job Title

Pay Terms
HourlyPer massageCommission PercentageSalaried

I work as a/an
Independent ContractorPrivate Practitioner - Self-employedPart-Time EmployeeFull-Time Employee

Did you find this practice through The Soma Institute’s Career Services office?
YesNo

Do you feel you are making satisfactory progress toward building a client base in the field?
YesNo

Have you earned income as a massage therapist?
YesNo

Do you feel you are making progress in achieving your vocational and monetary objectives?
YesNo

If you have answered no to any or all of the above questions, please explain.

Comments