AMOM · PROGRAM APPLICATIONS

Acupuncture Program Application

Complete the application for your chosen program. Admissions will review your information and contact you about next steps.

Acupuncture program application. Complete this program-specific application for admissions review. Preferred dates will be confirmed by the school. Ask a question first

Your acupuncture program

Acupuncture Certificate Program

Preferred start month *Admissions will confirm available start dates.

Personal and contact information

First name *

Last name *

Date of birth *

Email address *

Phone number *

Street address *

City *

State / province *

ZIP / postal code *

Education and healthcare background

Highest education level *

Previous acupuncture, healthcare or related education (optional)

Your goals or questions (optional)

Tell us about your preparation and goals. Background disclosures are reviewed by authorized staff; they are not automatic admission or rejection rules. Please do not include medical diagnoses or detailed incident records.

Education & professional experience

Education background * Schools, credentials, fields of study and approximate dates.

Work experience * Employment, volunteer or caregiving experience. Write "No previous work experience" if applicable.

Previous training & licenses

Have you attended another massage therapy school? *

Do you hold a massage therapy license in another state or jurisdiction? *

Do you hold another healthcare or related professional license? *

Do you have medical, healthcare or related training or work experience? *

Motivation & future plans

Why do you want to study acupuncture? * Tell us what interests you and what you hope to learn.

What do you plan to do after graduation? * Describe your employment, practice, further education or other plans.

Practical participation & professional conduct

With or without reasonable accommodations, can you safely participate in supervised practical training? * Practical tasks include controlled hands-on movements, safe body mechanics, following safety instructions, maintaining hygiene and respecting client boundaries. This question asks about program tasks, not a diagnosis.

Would you like information about student support or requesting reasonable accommodations? (optional) Do not provide diagnoses, treatment details or personal medical records in this application.

Confidential background disclosures

Do not report sealed, expunged or other records you are legally permitted to withhold. You may choose a private discussion. Detailed records can be requested separately if needed. An answer does not automatically determine admission.

Have you ever been convicted of a criminal offense? *

Have you ever been arrested? * An arrest alone is not evidence of guilt.

Have you ever been incarcerated in jail or prison? *

Confidential background and support answers are accessible only to authorized school administrators. They are excluded from routine application exports and admission emails.

Application documents & portrait

Upload your diploma and one government ID. Your documents are stored privately. JPG, PNG, WebP or PDF; maximum 8 MB each.

Diploma / GED image *

Passport, driver’s license or green card *

Portrait option

Your browser will ask for camera permission.

Required fields are marked *. Admissions will contact you about the next steps.