New Chair Massage Job Application Form Chair Massage Job Application Form "*" indicates required fields 1Step 12Step 2 First Name* Last Name* Street Address* City* State* Zip Code* Email* Phone*State(s) & License #(s) Year First Licensed Massage School Liability Insurance Y/N/Will Purchase ? Yes No Insurance Co. / Association How did you hear about Body Well? Are you or someone you live with a smoker? Please mark which of the following supplies you will definitely have at your disposal on short notice: Massage Chair in good condition(no visible or other damage) Essential Oil/Aromatherapy Make/Model and approximate age of chair What is your shirt size, for future reference? (please list in mens/womens sizes per your gender) 1. In what situations, if any, have you performed professional massage services until now: Offices Events Housecalls Clinical Setting Spa 2. Are you comfortable providing deep tissue work on chair clients? 3. List all days and hours that you are *POSSIBLY* available and would like to be offered an open assignment? (Keep in mind that you are never obligated to accept an offered assignment. You can also update this later as your availability changes) 4. PLEASE READ AND ANSWER CAREFULLY: Do you have a minimum average number of assignments per month that we *MUST* offer to you for you to be interested in joining our team? If yes, how many? 5. About how long are you willing to drive for an assignment assuming you are making at least $75-$100 including tips? 6. Most work is generally unsupervised, so it is important that our therapists agree to conform to some general policies and guidelines. On a scale of 1 to 10, what is your willingness & ability to take direction & follow instructions? 7. Are there any kinds of typical jobs or clients that you will not or cannot perform? 8. Are you willing to represent Body Well by wearing our provided T-shirt to assignments, along with your own black pants ( or perhaps nice black shorts/carpris)? 9. Are you open to receiving constructive feedback about your technique, supplies, performance, etc. either during or after the interview process? Yes No 10. Do you have a personal requirement that every client you touch signs a special liability waiver? (While Body Well requires that all therapist carry liability insurance, we do not require this.) Yes No 11. If we decide to offer mobile table massage in your area in the future, would you be interested in this opportunity as well? if yes, what modalities are you comfortable performing? No Yes Please specify* Photo (We receive applications every day. It is extremely helpful for us to put your name to a face. Please attach a photo if available.) You may also attach a resume if you wish.Accepted file types: jpg, gif, png, bmp, jpeg, Max. file size: 512 MB.Attachments (doc,docx,pdf,etc)Accepted file types: doc, xls, docx, xlsx, pdf, Max. file size: 256 MB.EmailThis field is for validation purposes and should be left unchanged.