Association Renewal Form

Association of Massage Therapists Scotland

Membership Renewal Form
I wish to apply for the following category of membership:*

StudentFull (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 treatments are you trained to perform? *

NeurodynamicsDry NeedlingCranial SacralCranial MobilisationKinesio TapingGait AnalysisPositional ReleaseMyofascial ReleaseMuscle Energy TechniquePeripheral Manipulation - Lower LimbPeripherial Manipulation - Upper LimbActive Isolated Stretching
Which of the following qualifications do you hold? **

Orthopaedic Massage and ManipulationAdvanced Remedial MassageSports TherapyRemedial and Sports MassageSwedish Massage
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.

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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 CodePhone Number
Phone Number

Area CodePhone Number
Work Number

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

YesNo
Type a question

I confirm that all details above are correct
Date*

DayMonthYear
Date

Payment

Membership£15.00

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Name*

First NameLast Name
Should be Empty:

Association of Massage Therapists Scotland

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