Apply To The Center For Neurosomatic Studies Interested in becoming a Neurosomatic Therapist, ready to apply or just want to learn more about NST? Connect with us. We can’t wait to speak with you. Ready To Get Started? Apply Now. First Name* Middle Initial:* Last Name Address Street Address City State / Province / Region ZIP / Postal Code Phone*Phone*Email* Highest Level of Education:Highest Level of Education:High SchoolAssociate DegreeBachelor's DegreeGraduate or Professional DegreeSome CollegeOtherPrefer Not to AnswerGraduation Date: MM slash DD slash YYYY Degree Attained: Name & Address of School:Emergency Contact Name & Relationship:Name & Address of EmployerHow Did You Hear About Us?How Did You Hear About Us?Tell us about yourself your interests, attributes, hobbies?Have you been convicted of a crime in the last 15 years? If so explain.Why do you want to be a Neurosomatic Therapist?How do you plan to finance your education?How do you plan to finance your education?Signature Date Signed MM slash DD slash YYYY Application Fee:CNS requires a nonrefundable application fee of $100 when you submit this application. If you wish to send a check or money order, please print and mail your application,along with your payment, to 13825 Icot Blvd. Suite 604, Clearwater, FL 33760. Application fees are refundable only in the event that you are refused acceptance with Center for Neurosomatic Studies. To pay with a credit card, please complete the information below authorizing us to charge the $100 application fee.Our ProductCredit Card* American ExpressDiscoverMasterCardVisaJCBMaestroSupported Credit Cards: American Express, Discover, MasterCard, Visa, JCB, Maestro Card Number Expiration Date Month Month010203040506070809101112 Year Year20222023202420252026202720282029203020312032203320342035203620372038203920402041 Security Code Cardholder Name