Apply to the Bright Moon Institute

Are you applying for a certificate program or a diploma program?

Select Certificate Program

Which Academic term will you apply for?

Are you currently an LMT?

Yes

Select Diploma Program

Which LMT Cohort will you apply for?

Legal Name *

Preferred Name

Address *

State *

City *

ZIP Code

Phone Number*

Date of Birth *

Email *

Driver's License State *

Driver's License Number *

Name *

Relationship *

Address *

Phone *

Education History

Did you Graduate your High school?

Yes

Please summarize your prior education history including any degrees trainings or certificates.*

Employment History

Please summarize your current and prior work history..*

How are you feeling in your body today?*

Is there anything about your health history that you would like us to know? How can we support your Academic success as a student?*

Did you make it to step 2?*

Yes

Please tell us a bit about yourself. What are your personal and professional goals?

Please describe your previous experience with healing arts including other courses, teachers and trainings you've been a part of previously.*

If you knew that you would have unlimited financial resources available to you, what would you do?

If you had the opportunity to write your own story, who could you be?

Do you have any criminal history of conviction of crimes of sexual misconduct or violent felony? Please describe.

Yes

Must successfully pass entrance interview
Must be 18 years of age
Must hold a High School Diploma or GED equivalent

Upload your photo ID here *

Please Note: I understand that this application does not guarantee a spot in the program but it will be reviewed. I understand selection shall be made on the basis of merit, aptitude and integrity. I acknowledge that failure to disclose complete and accurate information may result in the denial of admission or subsequent dismissal

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Education History

Employment History