The information I have provided is accurate, true, and correct to the best of my knowledge. I agree to inform NCBTMB of all changes to the information included in this application. I Understand that NCBTMB reserves the right to verify any and all information in this application or in connection with my Specialty Certificate. Therefore, I understand and agree that my failure to provide accurate, true and correct information or to respond to authorized NCBTMB requests for additional information shall constitute grounds for rejection of my application or denial or revocation of my Specialty Certificate. NCBTMB has the right to require retesting or revoke my Specialty Certificate if statistical aberrations are evident.
I have read, understand and agree to be bound by the policies and procedures, Code of Ethics, and Standards of Practice promulgated by the National Certification Board for Therapeutic Massage and Bodywork (NCBTMB). I understand and agree that my failure to abide by NCBTMB's policies and procedures, Code of Ethics, and Standards of Practice shall constitute grounds for rejection of my application or denial or revocation of my Specialty Certificate.
I understand that the demographic information provided on this application is confidential and will be used for aggregate purposes only.
I hereby attest that I am taking this examination for purposes to practice the information I am being tested on in which I have chosen to practice. I further understand that I am prohibited from transmitting information regarding examination questions or content in any form to any person or entity, and understand that failure to comply with this prohibition may result in my certificate being revoked and/or legal action being taken against me.I understand that the Specialty Certificate is NOT a substitute for my local and/or state licensing requirements.
I understand that my name, address and office contact information will become part of the registry of NCBTMB upon successful completion of the examination, unless I specifically request that my name not be released.
NCBTMB reserves the right to refuse any application that is not signed. All information that is submitted to NCBTMB, including photographs, may be provided to law enforcement agencies, and state, county and/or local governmental agencies upon their request and at the discretion of NCBTMB.