Is it okay for us to text you?

  • Yes
  • No

Gender (M/F)

  • Male
  • Female

Are you Hispanic or Latino?

  • Hispanic/Latino
  • Not Hispanic/Latino
  • Decline to Answer

Select one or more of the following races:

  • American Indian or Alaska Native
  • Asian
  • Black or African American
  • Native Hawaiian or Other Pacific Islander
  • White

Are you an employee of Parker University?

  • Yes
  • No

Is your spouse an employee of Parker University?

  • Yes
  • No

Is your father/mother an alumnus of our school?

  • Yes
  • No

Is your father/mother an employee of our school?

  • Yes
  • No

Are you currently on active duty?

  • Yes
  • No

Are you an United States veteran?

  • Yes
  • No

Are you here on a visa?

  • No
  • Yes

Are you naturalized?

  • Yes
  • No

Do you have an I-20?

  • No
  • Yes

Are you eligible for U.S. federal loans?

  • No
  • Yes

Have you taken the TOEFL test with a score of 550 (paper based) or 213 (computer based) or better?

  • No
  • Yes

Have you ever been charged with a criminal misdemeanor/felony offense?

  • Yes
  • No

Will you be requesting financial aid?

  • Yes
  • No

Do you have a history of any serious medical problems?

  • Yes
  • No

Do you have any muscle or skeletal injuries or communicable diseases?

  • Yes
  • No

Is medical supervision required?

  • Yes
  • No

Are you currently under a doctor’s care?

  • Yes
  • No

Are you currently taking any medication?

  • Yes
  • No

Any physical problems which may influence your effectiveness to give and/or receive massage therapy?

  • Yes
  • No
  • Check box to receive a copy of the submitted application.
MyParkerPRD01