Massage Therapy Application Please enable JavaScript in your browser to complete this form.Galveston College's Massage Therapy Program has an admissions process. This process is non-discriminatory on the basis of race, color, national origin, gender, age, qualified disability, marital status, veteran’s status, or sexual orientation in admissions to the program. Note: It is the student’s responsibility to provide the program director written notification of any changes in contact information. Name (required) *FirstLastPhone (required) *Email (required) *Date of Birth (required) *Example 00/00/0000AddressAddress Line 1Address Line 2CityAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodeDo you need help with the following?Payment PlanFinancial AssistanceAssistance Signing UpComment *NameSubmit