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 receive regular news and important updates via email?

Yes

Would you like to receive regular news and important updates via sms?

Yes

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