TMJ (Jaw) Application

Vancouver School of Bodywork and Massage Ltd. Vancouver School of Healing Arts -
Suite 300-­ 342 Water Street
Vancouver BC V6B 1B6
phone: 604-­688-­5060 fax: 604-­688-­4166

PTIB Registration #: 3187
PTIB Designated:
Student Information
Student Last Name
Student First Name and Middle Name
Student Usual First Name
Student Previous Last Name (if applicable)
Student Previous First Name (if applicable)
Student BC Mailing Address
Postal Code
Student Permanent Mailing Address
(including country)(if different from above)
Postal Code
Student Telephone Number
Student Email Address
Cellphone Number
International Student:
Date of Birth:
Program Information
Program Name
TMJ (Jaw) Massage

Program Duration in Hours
Program Duration in Weeks
Program Start Date
Program End Date
Program Delivery Method
Language of Instruction
Refund Policy
1) A student may be entitled to a refund of fees in the event that:
  • (a) The student provides written notice to the institution that he or she is withdrawing from the program one week in advance.
2) If written notice of withdrawal is received after the one week cancellation policy and prior to the start of the course, the student can:
  • (a) Transfer to the next available course, or;
  • (b) Forfeit all fees paid.
Student Declaration
  • The program of instruction does not require approval under the Private Training Act;
  • I may not file a claim against the fund with the trustee in respect of the program of instruction;
  • I understand that is contract is a legally binding agreement between myself and The Vancouver School of Healing Arts

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Signature Certificate
Document name: TMJ (Jaw) Application
lock iconUnique Document ID: 54f21a269641e6a64e2ee4af462e27dbbc3f2aff
Timestamp Audit
August 9, 2018 3:31 pm PDTTMJ (Jaw) Application Uploaded by Val McKinnon - IP
August 9, 2018 3:42 pm PDTVal McKinnon - added by Val McKinnon - as a CC'd Recipient Ip:
March 8, 2019 12:15 pm PDTVal McKinnon - added by Val McKinnon - as a CC'd Recipient Ip: