Thai Yoga Massage Association of New Zealand

Thai Yoga Massage Association of New Zealand

Thai Yoga Massage Association of New Zealand

Membership Application Form

LEVEL OF MEMBERSHIP YOU APPLYING FOR?

Please tick the appropriate box/s
ASSOCIATE:
For people who wish to support the association and who are not currently a practitioner in Thai Yoga Massage Cost NZ$20
PRACTITIONER:
For people who have completed a minimum of 160 hours tuition from a TYMANZ approved Training Institution. Cost NZ$50

THERAPIST: For people who have completed a minimum of 320 hours tuition from a TYMANZ approved Training Institution. Cost NZ$50

THAI MASSAGE MASTER:For people who have completed a minimum of 750 hours tuition from a TYMANZ approved Training Institution. Cost NZ$50

CORPORATE:
For organizations, or businesses who wish to support the Association. (includes web listings) Cost NZ$100
PERSONAL INFORMATION
FIRST NAME / SURNAME
BUSINESS NAME (if applicable)
ADDRESS
CITY / STATE / PROVINCE / POST CODE / COUNTRY OF RESIDENCE
E-MAIL / WEB SITE URL / TELEPHONE
COMPLETED TRAINING IN THAI YOGA MASSAGE
List the name of each training course you have completed, the name of your teacher, school, location, date of completion for each course and total hours studied.
If any of the training you received was with teachers or schools that are not yet approved by TYMANZ, please include that training below and then complete the contact information which follows in the next section.
(a full list of currently approved Teachers & Schools are listed on the bottom of this form.
Please include photocopies of your Certificates or Diplomas. (Photocopies only)
COURSE NAME TEACHER OR SCHOOL LOCATION DATE HOURS
If any of the training you received was with Teachers / Schools that are not yet approved by TYMANZ, can you also list contact details for those Teachers / Schools below.
N.B. You may be required to undertake an assessment by a senior member of the Association under these circumstances.

Teacher or School Name Complete address plus Email Telephone

DOCUMENTED CLIENT REPORTS
TYMANZ requires that you include copies of Documented Client Reports with your application, to confirm that you have attained a relevant level of experience after your training, for the following categories
(not applicable for Associate or Corporate Memberships) N.B. These copies will not be returned.
Practitioner – 10 reports
Therapist – 50 reports
Thai Massage Master- 100 reports
These should include: date of massage, client number (to preserve client confidentiality), presenting problems, methods used to treat those problems and any general notes about the massage.
N.B. Client Reports must be for full 2 hour massages only.
All information will be kept strictly confidential and if we need contact with the client for conformation purposes, then, we will discuss this with you directly.
PLEASE ANSWER THE FOLLOWING QUESTIONS ABOUT YOUR PRACTICE AND ONGOING STUDY.
TYMANZ members are required to pursue ongoing study totaling a minimum of 30 hours per year. This can be in the form of:
on going training, researching written material, massage exchange with other therapists etc.
Describe ways in which you will most likely accomplish this ongoing study.
Are you qualified in any other modalities? (e.g. Homeopathy, Swedish Remedial massage etc)
If yes, please list all appropriate information here.
Do you hold a current workplace First Aid Certificate YES -- NO (circle the one applicable)

The Thai Yoga Massage Association of New Zealand Ethical Code

  1. CLIENT FOCUS
    To consider at all times your first priority and duty to be the health and wellbeing of your client
  2. PROFESSIONALISM
    To ensure your professional ability and integrity is your primary duty and concern.
  3. RECOGNITION OF LIMITATIONS
    To recognise your limitations and the specialised skills of others in the prevention and treatment of illhealth and disease.
  4. RESPECT FOR OTHER PRACTITIONERS
    To honour and respect the skills of your professional colleagues and uphold your profession and its ongoing traditions.
  5. DILIGENT STUDY
    To improve your professional knowledge (using current research) and upgrade your skills, so that the best possible advice and available treatment can be afforded to your client.
  6. CONFIDENTIALITY
    To maintain confidentiality of patient information at all times unless a legal duty of disclosure is demanded in a particular case of law.
  7. ACCREDITATION
    To maintain at all times accreditation at the level to which your knowledge and skills of Thai Yoga Massage, apply.
  8. PRACTITIONER / CLIENT RELATIONSHIPS
    To uphold acceptable guidelines for practitioner/patient relationships; these must be maintained on a professional and treatment protocol basis only.
  9. BE GRATEFUL
    To maintain a spiritual approach to my professional healing practice, and to continually work through my practice for the betterment of myself, my clients and mankind.

I certify that all the information listed above is correct,and that I have studied and practiced the number of hours listed on this form. I understand that TYMANZ may contact my teachers, clients or institutions to verify this claim. I further agree to abide by and to uphold the above code of ethics as key to maintaining membership with the Thai Yoga Massage Association of New Zealand.

Sign your name / Date

Please Post or Fax this application to:

The Secretary - TYMANZ
95 Gatland Road

Papakura 2113

New Zealand
Phone / FAX number +64 9 2982007 Email

Have you:

  1. Included copies of certificates of your relevant training courses?
  2. Included copies of Client Reports?
  3. Included the required payment? (can be paid by Visa or Mastercard through Paypal Email above)
  4. Signed and dated this form?

The following is a list of Teachers/Training Establishments currently recognised by TYMANZ
AUSTRIA
Veni Labi, Wasagasse
Franziska Scharler
Rachna König
Shanti Kuttelwascher
Egon Kronfuss

ARGENTINA
Centro Brillo Del Sol - Buenos Aires
BRAZIL
David Lutt

CANADA
Circle of Life School of Thai Massage - Fairmont Hot Springs
Kristin Nuttall – Whistler
Chow Kam Thye
Gordon Waselnuk
CHILE
Tania Heymann

CROATIA
Davor Haber – Zagreb

ENGLANDBritish School of Thai Bodywork – DorsetKira BalaskasKate Ellis

Ralf Marzen - London
Fiona Smith – Stamford
Catherine Waller
Nicky Smith
Amy Ku Redler
Andrea Baglioni
Felicity Keebaugh
Lara Pearson

FRANCE
Charles Breger – Savignies
David Lutt
Arnaud L'Hermitte

GERMANY
Hans Luetz – Bonn
Vera Lier
Alwin D'Angelo
Ralf Marzen
Evelyn Unger
Lucia Ullrich
GREECE
KrishnaTaki Economoy
Fiona Smith
Robert Henderson

INDIA
Prabhat Menon
Itzhak Helman
Fiona Smith
IRELAND
Robert Henderson

ITALY
Laurino Bertelli
Andrea Baglioni
Dr. Carla Possanzini
Dr. Ermanno Visintainer
Cristina Radivo
Roberta Mugnai
Corinne Crosina

JAPAN
Academy of Thai Yoga Massage -Tokyo
NEW ZEALAND
Sunshine Network New Zealand – Auckland
Zane Williams
Jo Biss

SCOTLAND
Thai Massage Organisation – Edinburgh
SPAIN
Choenzom Emchi Diaz
Nicky Smith

SERBIA
Institute of Thai Massage Belgrade – Belgrade

SWITZERLAND
Chantal Galloppini Blanc
Choenzom Emchi Diaz

THAILAND
Aum Health School - Chiang Mai
International Training Massage (ITM) - Chiang Mai
Lanna Thai Massage School - Chiang Mai
Loi Kroh Thai Massage - Chiang Mai
(Mac) Therdchai Chumphoopong - Chiang Mai
Mama Nit Thai Massage (Baan Nit) - Chiang Mai
Nerve Touch Massage School - Chiang Mai
Old Medicine Hospital (Shivagakomarpaj Foundation) - Chiang Mai
Phussapa Thai Massage School- Bangkok
School of Massage For Health, Sripoom - Chiang Mai
Sunshine Massage School- Chiang Mai
Thai Massage School of Chiang Mai (TMC) - Chiang Mai
Wat Po – BangkokAsokananda (deceased)
Chaiyuth Priyasith (deceased
(Pichet) Pichest Boonthumme - Hang Dong
UNITED STATES
Tanya Boigenzahn - Minnesota
Elyse Briggs - California
Paul Fowler - Illinois
Richard Gold - California, and other locations
Bob Haddad - North Carolina, and other locations
Tim Holt - California
Institute of Thai Massage - New Jersey, and other locations
Martin Misenhimer - New York, and other locations
James Peckham - New Mexico
Kay Rynerson - Seattle, Washington
Souri Sisavath - Texas
Spirit Winds School of Thai Massage - California
Eric Spivack - Seattle, Washington
D’vorah Swarzman – Ashland, Oregon
Al Turner II - New York City, and other locations
Soul D. RayeSanta Monica
David Weitzer - Portland, Oregon
Tod Overstreet San Francisco
Jodie Ellis, Arcata Ca
Kaline Alayna Kelly NY
Scott Jernigan
Brian Dobbs

N.B. Not all courses run by the above qualify as accepted hours

Top View