AMT

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

I wish to have insurance information sent to me. (If you select yes, we will arrange to have insurance policy information sent to you when your membership is approved).

Yes

Police Check Expires On

Please do not upload the following checks Working with Children (WWCC), Working with Vulnerable People (WWVR) or Aged Care, we do not require a copies of these checks.

Police Check Evidence

File Description

Referral source

Referral source other

Join reason

Join reason other

Rto

Rto other

Course

Expected Course Completion Date

You must attach proof of enrolment that clearly shows your name, the name of the course you are enrolled in, the school you are attending and the anticipated completion date. Your application will not be processed without proof of enrolment.

Proof of enrolment

Proof of enrolment file description

Other Association Proof

Other association provider

List three (3) character referees (name and telephone number) from persons other than family who have known you for the last two years

Referee Name

Phone

Referee Name

Phone

Referee Name

Phone

Fitness to Practice

Have you been the subject of any formal complaints or investigations over the past 12 months that would affect your fitness to practice as a massage therapist?

Have you been the subject of any disciplinary, legal or criminal proceedings over the past 12 months that would affect your fitness to practice as a massage therapist?

If you answered yes to either of these questions, please email a written explanation to info@amt.org.au

Declaration Statements

I have reviewed the standards in the AMT Code of Practice, and will abide by the AMT Code of Practice, the AMT Code of Ethics and any other applicable codes and regulations

I declare that the information given on this form is true and correct.
I understand that:

I must pay all my subscriptions and other monies due until I resign my membership
I declare that I will abide by the AMT Code of Ethics and any applicable rules, codes and regulations
I declare that I will abide by all applicable health fund provider terms and conditions

I declare that the information given on this form is true and correct.

Yes

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New Student Registration

Fitness to Practice

Declaration Statements