AMT

New Application

Title

First name*

Last name*

Gender

Personal Email*

Please upload a recent passport-size photo:

Address*

Address 2

Suburb*

Australian state

Postcode*

Mobile phone*

Home phone

Website

DOB

Would you like to subscribe to the AMT Blog?

Yes

Application Fee. This is a non-refundable fee, which must be sent with your Application :

$20.00

Paying via Credit Card?

Yes

Other Methods of Payment

Pay by direct deposit:
Commonwealth Bank
Account Name: Association of Massage Therapists Ltd
BSB: 062-212
Account Number: 1034-0221
Payment Reference: please use your name as reference

Pay over the phone with a credit card; please call 02 9211 2441

Name on Credit Card