Expression of Interest - Durham College Massage Therapy Pathway

Use this form if you are a current Ontario Tech undergraduate Kinesiology student, who upon graduation, intends to pursue the Massage Therapy Advanced Diploma program offered by the Durham College with advanced standing.

Completion of this form and subsequent registration in specific Kinesiology elective courses does not guarantee your admission to the Massage Therapy Advanced Diploma program at Durham College.

Please complete this form prior to June 20th in order to ensure access to the elective courses necessary to pursue this pathway:

• KINE 4413U Exercise Rehabilitation and Management
• KINE 3476U Advanced Sport Injury Management
• KINE 4150U Foundational Skills and Techniques for Massage Therapy

Please consult with your Academic Advisor for additional details.

Student ID:
Must be 9 characters. Currently Entered: 0 characters.
Name: Name: First Last
Date of Birth Date of Birth / MM / DD YYYY
Student Email Address:
Declaration:
I declare that the information contained within this form is accurate to the best of my knowledge.
Student Signature (type your name in full):
Acknowledgement:

Acknowledgement: I understand that this is a legal representation of my signature.
Personal information on this form is collected under the authority of the University of Ontario Institute of Technology Act, SO 2002, c. 8, Sch. O. and will be collected, protected, used, disclosed and retained in compliance with Ontario’s Freedom of Information and Protection of Privacy Act R.S.O. 1990, c. F.31. This information will be used for education, administrative and statistical purposes and to administer registration within the University. Questions regarding the collection of your personal information may be directed to the Registrar, 2000 Simcoe Street North, Oshawa, ON L1G 0C5, 905.721.3190, email: connect@ontariotechu.ca.

Accessible formats for this document are available upon request. Please contact records@ontariotechu.ca.

Expression of Interest - Durham College Massage Therapy Pathway

Expression of Interest - Durham College Massage Therapy Pathway

Declaration: