Association Renewal Form

Association of Massage Therapists Scotland

Membership Renewal Form
Name * *

First Name Last Name
* To be used in the Find a Therapist database
I wish to apply for the following category of membership: *

Student Full (must be qualified to Remedial and Sports Massage or above. Only full members will be entered on the Find a Therapist database)*
Which of the following qualifications do you hold? * *

Orthopaedic Massage and Manipulation Advanced Remedial Massage Sports Therapy Remedial and Sports Massage Swedish Massage Cranial Sacral Dry Needling
Which of the following treatments are you trained to perform? *

Neurodynamics Kinesio Taping Gait Analysis Cranial Mobilisation Positional Release Myofascial Release Muscle Energy Technique Peripheral Manipulation - Lower Limb Peripherial Manipulation - Upper Limb Active Isolated Stretching
CPD (Continued membership requires 20 hours of coursework/workshops each year.
Qualifications gained within the last year (1 Mar - 28 Feb)
CPD Courses/Workshops attended within the last year (1 Mar - 28 Feb):
Please enclose a copy of all course certificates gained within the year.

Browse Files

Cancel of
CPD Requests. I would like workshops on the following to be run:
Please give any changes to your address or personal details below. If there are no changes please leave blank.
Address *:

House Name/Number

Street

Town/City

Postcode * (To be used in the Find a Therapist database)
E-mail
Mobile Number

Area Code Phone Number
Phone Number

Area Code Phone Number
Work Number

Area Code Phone Number
Website *
I am happy to receive information on forthcoming courses and other relevant information

Yes No
Signature *

Clear
Date *

Day Month Year
Date

Payment

Membership £ 10.00

Credit Card

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Association of Massage Therapists Scotland

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