Massage Therapist Step 1 of 6 16% Personal InformationFull Name* Email* PhoneAddress Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Massage Therapy CredentialsDo you hold a valid massage therapy license in the state of CT? Yes No If yes, please provide your license number and expiration date:* Have you completed any additional certifications or specialized training in massage therapy? Yes No If yes, please specify:* Education and TrainingDo you have formal training in massage therapy from an accredited school or program? Yes No If yes, please provide details (school name, location, and dates attended): Professional Experience:How many years of experience do you have as a massage therapist? Massage Techniques and ModalitiesWhich massage techniques are you proficient in? (e.g., Swedish, deep tissue, hot stone, prenatal, aromatherapy, etc.) Do you have experience with any specialized massage modalities? Yes No If yes, please specify: AvailabilityAre you available to work on weekends, evenings, and holidays? Yes No Are you seeking full-time or part-time employment? Full-Time Part-Time Additional InformationIs there anything else you would like us to know about your qualifications, skills, or experience as a massage therapist? References:Please provide the names and contact information of at least two professional references who can speak to your massage therapy skills and work ethic.Consent* By submitting this application, I certify that the information provided is accurate and complete to the best of my knowledge. The Submission of an application does not guarantee employment and that only selected candidates will be contacted for an interview.