Lang Institute for Canine Massage Application Form - The Lang Institute for Canine Massage

Personal Information

Name *

Street Address *

Apartment, suite, etc

City

State/Province

ZIP / Postal Code

Country

Phone *

Phone (Secondary)

Email *

Date of Birth *

Emergency Contact Information

Name *

Street Address

Apartment, suite, etc

City

State/Province

ZIP / Postal Code

Country

Phone *

Phone (Secondary)

Education Overview

High School

College

Professional Licenses, Certifications, Accrediations, or Training

Animal Experience

Please indicate how many hours of animal experience you have.

Pet owner (past and present)1 dog 2-5 dogs 5-10 dogs 11+ dogs

Veterinarian Assistant1 year 2-5 years 5-10 years 10+ years

Veterinarian1 year 2-5 years 5-10 years 10+ years

Pet Groomer1 year 2-5 years 5-10 years 10+ years

Pet Shop Owner1 year 2-5 years 5-10 years 10+ years

Animal Shelter Worker1 year 2-5 years 5-10 years 10+ years

Animal Shelter Volunteer1 year 2-5 years 5-10 years 10+ years

Canine Rescue Work1 year 2-5 years 5-10 years 10+ years

Obedience Instructor1 year 2-5 years 5-10 years 10+ years

Other Dog Sport Instructor1 year 2-5 years 5-10 years 10+ years

Dog Show Competitor1 year 2-5 years 5-10 years 10+ years

Dog Breeder1 year 2-5 years 5-10 years 10+ years

Other Canine Contact1 year 2-5 years 5-10 years 10+ years

Tuition Payment Plan Selection

The Lang Institute offers four payment plans. If you choose Plan C or Plan D, we will send you a schedule of payment dates.

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Plan	Schedule of Payments	Total Tuition Cost
A	EARLY BIRD SPECIAL! Only $3,750 if paid in full by March 1, 2024.	$3,750.00
B	One Payment of $3,900.00. Due two weeks before beginning Module 1.	$3,900.00
C	Two Payments of $2,145.00 each.	$4,290. Plan B includes a 10% finance charge of $390.00.
D	Twelve Payments of $373.75 each.	$4,485.00 Plan C includes a 15% finance charge of $585.00

There will be a 3% charge on all credit card payments over $250.00

Total tuition costs may vary according to grants available.

Select *Only select 1 option.

Other Expenses

The Lang Institute for Canine Massage will accept payment by money orders, cashier’s checks, Visa, MasterCard, personal check, or VENMO. (All material will be held for 15 days for check clearance.)

Students should also expect to pay for other costs for required materials, travel, meal, and accommodation expenses and any related or ancillary expenses. These additional expenses may and can vary by region. Obtaining these required materials or incurring these expenses is the responsibility of the student.

Books, charts, supplies: $175.00 – $200.00 [estimate]
Four massage therapy sessions: $200.00 – $300.00 (rates can and may vary)
A third-party canine CPR class: $30.00 [estimate]
Travel, meals, accommodation expenses, and any other related or ancillary charges.

If you are not a U.S. Citizen or a lawful resident of the United States of America, it is your sole responsibility to obtain and pay any required fees or charges for any required visa, permit, approval, or permission from the appropriate agency of the United States Government to travel to the United States of America and to be a student at the Lang Institute.

Modifications

While every effort is made to ensure the accuracy of information in this Enrollment Application and in the Lang Institute’s Catalog, on its website, and in any other materials written or issued by the Lang Institute at the time the copy for such is prepared for publication, printing, or posting on its website, the Lang Institute fully reserves the right to make any changes, additions, and/or deletions to its Enrollment Application, Catalog, website, or any other materials written or issued by the Lang Institute without prior notice and to apply such changes to applicants and new and current students alike.

Acceptance of Program Policies, Requirements, and Curriculum as specified in L.I.C.M. Catalog #4 Edition Aug. 2007-2023

Mailing Address and Contact Information

Hit the submit application button below to agree to all of the above. Or, print and fill out the application and send it--along with your tuition plan selection, your initialized “Acceptance of Program Policies, Requirements, and Curriculum” form, and the $150.00 application charge (made payable to Joanne Lang, Inc.) to:

Lang Institute for Canine Massage
P.O. Box 2786
Loveland, Colorado 80539-2786

If you have any questions about this application or the program or you would prefer to fill out a PDF of the application form to send in, you may contact us at the above address, by calling 970-691-3985, or by emailing lang@dogmassage.com. You may also visit our website at www.dogmassage.com for additional information.