Professional Reference

Once this form is completed and submitted please expect

up to five business days for processing and submission

of your professional reference.

BY COMPLETING THIS FORM I HEREBY AUTHORIZE CARLSON COLLEGE OF MASSAGE THERAPY TO RELEASE PROFESSIONAL REFERENCE INFORMATION INCLUDING, BUT NOT LIMITED TO, COURSE GRADES, ATTENDANCE, PROFESSIONALISM, TEAMWORK, AND OVERALL PERFORMANCE WHILE BEING A STUDENT AT CCMT.

Name

First Last

Signature

Name of business or person who we may communicate with on this professional reference