APPLICATION FOR MEMBERSHIP OF THE AAOMT
REQUIREMENTS: FOREIGN TRAINED OSTEOPATHS
You must submit the following documents with your membership
application:
1. School Transcript
An official transcript of your academic and training record, signed by the Dean or Registrar, from the osteopathic school from which you graduated. The transcript should include:
a) the dates you attended the school
b) all subjects of the osteopathic curriculum
c) your evaluation results
d) the date you graduated
• the official transcript must be mailed the AAOMT directly from the school
• photocopies are not acceptable
2. Diploma or Certificate
A photocopy of your diploma or certificate from an osteopathic college that has been approved by the AAOMT. The AAOMT may ask to see the original of this document before accepting your membership application.
3. Passport-size Colour Photo
A recent (taken within the last 6 months) passport-size colour photograph of yourself. You must sign and date the photograph (at the bottom).
4. Two Letters of Recommendation
These letters can be from a lawyer, a physician, or any other health practitioner in Alberta. The person writing the letter must have known you for at least 6 months, if not please explain why. These recommendations will be checked so make sure that the person recommending you is happy to be contacted.
Please return all the above with your application to:
RR 1 Site 3 Box 7, Olds Alberta T4H 1P2
APPLICATION FORM: FOREIGN-TRAINED OSTEOPATHS
Name:______
Surname (include birth name or other names used) Given Name(s)
Home Address:
______
Street No. Apartment no. City
______
Province/State Postal/Zip Code Country
Phone______Email:______
Mailing Address: (if different from above)
______
______
______
EDUCATION
School Graduated: ______
Diploma Received: ______
Year Graduated: ______
EMPLOYMENT HISTORY
1. Company Name: ______
How Many Years : ______
2. Company Name: ______
How Many Years : ______
3. Company Name: ______
How Many Years : ______
4. Company Name: ______
How Many Years : ______
PROFESSIONAL ACTIVITIES
(Professional organizations to which you belong)
______
______
______
My signature below certifies the above information to be true and accurate.
______
Signature Date
Alberta Association of Osteopathic Manual Therapists