Your Email Address *

TO complete CLICK 'SUBMIT' AND YOU WILL BE RE-DIRECTED TO PAYPAL FOR PAYMENT. if you wish to make payment through paypal complete the transaction there. If not, close paypal out and call us at 319-462-3402 to make payment over the phone.

Comments

Address: *

City/State: *

Electronic Signature authorizing release of your information (must also call with confirmation)::

Zip Code: *

Date: *

For the duration of (indicate length of program, if current student)::

Name of Institution or business that transcripts or materials are to be sent: *

Contact Person/Authorized person to receive your educational or financial materials as indicated above:

Your Name: *

Your Phone Number *

Carlson College of Massage Therapy FERPA Release

Please fill out the following form to release information to a third party. You will need to pay $7.50 to CCMT (call 319-462-3402 to pay over the phone, send a check or use PayPal) for each transcript.

Please note this $7.50 fee is only for the transcript. Should more documents need sent there will be additional fees.

I, the undersigned hereby authorize Carlson College of Massage Therapy to release the following educational records and information.

TO complete CLICK 'SUBMIT' AND YOU WILL BE RE-DIRECTED TO PAYPAL FOR PAYMENT. if you wish to make payment through paypal complete the transaction there. If not, close paypal out and call us at 319-462-3402 to make payment over the phone.

Carlson College of Massage Therapy FERPA Release

I, the undersigned hereby authorize Carlson College of Massage Therapy to release the following educational records and information.​

I, the undersigned hereby authorize Carlson College of Massage Therapy to release the following educational records and information.