Job Application | Embody Wellness

JOB APPLICATION

First Name

Last Name

Email

Address

Phone Number

How did you hear about Embody Wellness?

What times during the day are you typically available?

How soon could you start?

Do you have reliable transportation?

Yes

No

Do you have a massage chair?

Yes

No

PERSONAL INFORMATION

Are you at least 18 years of age?

Yes

No

Are you a U.S. Citizen or approved to work in the U.S?

Yes

No

Do you have any conditions which would require job accommodations?

Yes

No

If YES, please explain:

Have you ever been convicted of a criminal offense?

Yes

No

If YES, please explain:

Have you ever had a complaint filed against you, officially or unofficially?

Yes

No

If YES, please explain:

Have you ever had your massage certification/license suspended or revoked?

Yes

No

If YES, please explain:

JOB SKILLS/QUALIFICATIONS

Please list the skills/modalities & qualifications you possess for the position for which you are applying:

EDUCATION AND TRAINING

Do you have a high school diploma or equivalency?

Yes

No

CAMTC Certificate Number:

VOCATIONAL SCHOOL / SPECIALIZED TRAINING / MASSAGE SCHOOL

Are you comfortable with a smartphone/apps?

Yes

No

Are you comfortable with technology?

Yes

No

Do you have any knowledge of Aromatherapy?

Yes

No

Do you do Cupping?

Yes

No

Please explain your experience with Massage and the Health and Wellness industry

MASSAGE EMPLOYMENT HISTORY

Do you have a private practice or would like to build one? (Explain)

Most Recent Employer’s Name:

Job Title:

Employer’s Address:

Supervisor’s Name:

Employer’s Phone Number:

Dates of Employment:

Reason for Leaving:

Another Past Employer’s Name:

Job Title:

Employer’s Address:

Supervisor’s Name:

Employer’s Phone Number:

Dates of Employment:

Reason for Leaving:

Please provide 3 non-family references that you have given massage to:

Name

Contact Info

Type and length of relationship

Name

Contact Info

Type and length of relationship

Name

Contact Info

Type and length of relationship

Any additional Comments:

When was your last massage?

How frequently do you receive bodywork?

Do you agree to receive bodywork at least every other week?

Yes

No

Do you agree to continue your education in some way each year?

Yes

No

Are you comfortable working on a team?

Yes

No

Are you comfortable working independently?

Yes

No

Are you comfortable working on men and women?

Yes

No

If NO, please explain:

Are you comfortable asking clients to rebook a session?

Yes

No

If NO, please explain:

If you have any issues with submitting your application, please scroll up and make sure all required fields are completed. If the issue persists, please contact us at (805) 217-3307. Thank you!