Contact Information:

    First Name:
    Middle Initial:
    Last Name:
    Mailing Address:
    Town/City:
    Province:
    Postal Code:
    Phone:
    Email:
    Date of Birth:
    School Attended:
    Date of Graduation:

    Certification Examinations:

    The OSCE portion of the Certification Examination is offered on specific dates during the year. Please consult with the Candidate Handbook for specific dates. This application can be used for applying for both the OSCE and MCQ examinations. A new application must be submitted each time an applicant wishes to apply for another examination (special accommodations must be submitted 3 months prior to an examination date).



    What Examination(s) are you applying for?

    OSCE Dates (please select month):
    OSCE Rewrite?
    MCQ Dates (please select month):
    MCQ Rewrite?


    Are you applying for special testing accommodations?


    Examination Fees and Payments:

    OSCE: $850

    MCQ: $550

     

    *Once payment is processed Candidate is charged a $150 non-refundable administrative fee.

    NOTE: Candidates will be sent payment options details once their exam application has been approved and slot is confirmed.



    Required Documents:

    Candidates are required to provide an electronic copy of a Government issued photo ID and a transcript OR letter of enrollment (Formats for upload can include PDF, JPG, etc.). Please attach a copy below, otherwise, you will be required to provide a copy by mail or fax.

    1. Government issued photo ID: 2. Transcript OR Letter of Enrollment:

    Acknowledgements:

    I acknowledge that the personal information on the above form is used by the College to administer the Massage Therapy Act 2005, the Regulations, By-Laws, Policies, the standards of practice and for research and other projects related to the governance of massage therapists and is collected, used and disclosed in accordance with the College Privacy Code. I have completely read and understand the candidate information and procedures stated in the Candidate Handbook and signed below as proof of doing so.

    Signature:
    Date:

    Please answer the following questions:

    Have you been found guilty of a criminal offence related to the regulation of the practice of massage therapy?

    Have you been found guilty of a professional misconduct, or incompetency in any jurisdiction in relation to the practice of massage therapy or any other health care profession?

    Are you subject to any current proceedings for professional misconduct, incompetency or incapacity?

    Have you been convicted or charged with, and not yet been found guilty or acquitted, of an offence that affects your fitness to engage in the practice of massage therapy?

    Have you attempted/completed any portion of a regulatory examination with CMTNB, CMTO or CMTBC?

    If you answered Yes to any of the above questions, please provide details:


    Signature and Submission

    Please note that failure to answer any of the above questions or failure to sign the statement below constitutes grounds for rejecting this application for the College of Massage Therapists of Newfoundland and Labrador certification examination. Furthermore, inaccuracies in this application discovered at a later date will be grounds for the immediate revocation of any registration with the CMTNL issued based on this application.


    I agree to abide by the Massage Therapy Act, 2005 and the Regulations and Policies of the College of Massage Therapists of Newfoundland & Labrador (CMTNL).


    I verify that all statements contained in this application are accurate and I give my permission to the CMTNL to contact any school, association or college with which I have been involved to verify any information given.



    Signature:


    Date: