Emergency Contact Name*
Emergency Contact Phone Number*
Position Desired With Company*
Are you fully insured to perform services in your profession? If not, how soon can you obtain your insurance?*
Time length to obtain insurance?
Insurance Co. / Association Name
Name of Professional Certification School
From (mm/yyyy) To (mm/yyyy)
Extra Certifications/License/Training in Scope
Name of Company 1
Employer's Street Address
From (mm/yyyy) to (mm/yyyy)
Responsibilities & Skills
Name of Company 2
Name of Company 3
Please check which kinds of assignments you are interested in:
Home Outcalls (Condos / Yachts / Houses / Apartment)Hotel Outcalls (In Room Hotel Suite / Hotel Spa Rooms)Chair Massage (Corporate / Business / Office Events)Spa Parties (Bridal Showers/ Birthdays / Anniversaries / Charities / Sporting Events)
How did you hear about Eminence Massage?
Are you looking for a career that will allow you more professional freedom?
Do you have a desire to help others?
Do you see yourself as a nurturing person?
Would you like having a flexible work schedule?
Do you enjoy working one on one with people?
Do you consider yourself a good listener, with positive interpersonal skills?
Would you enjoy working in various calm healing and even zestful spa ambiance environments?
Can you perform side by side with other professionals in various settings such as spa parties, corporate or chair massage events?
Do you have access to smart phone?
List ALL days and hours that you are 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)
How far are you willing to commute for an assignment?
What would be the latest start time in the evening you could possibly be available for an out call?
Are there any kinds of clients you will not work with (besides sexually suggestive), e.g. "single men", "geriatric" children. etc.? If so please list here
Are you willing to represent Eminence Massage by wearing suitable clothing for the treatments you are providing? Such as white scrubs, white tunic, white linen pants or jeans. Uniforms must be completely free from any heavy scents such as perfume, cologne or smoke. Eminence massage will provide uniformed shirts for spa parties, sponsored events and any corporate or chair massage event. For any event we will structurally provide your uniform in advance.
Applicant agrees to be on time as scheduled; to act and behave courteously professional toward clientele; to keeping the SAFE, CLEAN, CALM, COMFORTABLE set up/environment for both professional & clients; and to adhere to updated Mobile Spa policies
As a Massage Therapist would you enjoy coaching people on better ways to care for their bodies?
Are you interested in learning about human anatomy and how the body moves and functions?
Do you enjoy working with your hands?
How many massages do you feel most comfortable providing in a day?
As a massage therapist on a scale from 1-10 what is your comfort level performing body wraps and body scrubs? Assuming you were taught in massage school. If not you will be fully coached on performing these treatments.
Have friends/family told you that you would make a great massage therapist?
Are there any specific modalities of massage that you feel most comfortable performing? Please list them.
In what situations, if any, have you performed professional massage therapy until now (i.e. house calls, chiropractic offices, spas, etc.)?
HomeHotelOfficeYachtsSpaSalonMassage ClinicChiropractic or PT ClinicEvent Chair MassageSponsored EventsOther
You will be required to provide upon applying for work with Eminence Massage, specified equipment to utilized by you as a professional practitioner in your trade. Please mark which of the following supplies which you as a certified professional being massage therapist, esthetician or cosmetologist can assertively carry out mobile spa treatments on short notice:
Massage Table in good conditionAdjustable face cradleBattery Operated CandleEminence Body Scrub MaterialEminence Body Wrap MaterialPortable Music Material (Radio w/c.d or Smart Phone w/itunes, pandora)Fresh Linens (plain/solid color in good condition)Massage Lotion / Creams - None ScentedEssential Oil/Aromatherapy
As an Esthetician would you enjoy coaching people on there skin?
Have friends/family told you that you would make a great skin care specialist?
What would you say is your most skin enhancing treatment you have performed on a client?
Have you ever performed a body wrap or a body scrub treatment?
In what situations, if any, have you performed professional skin care services until now (i.e. house calls, chiropractic offices, spas, etc.)?
HomeHotelOfficeYachtsSpaSalonMassage ClinicChiropractic or PT ClinicEvent Chair MassageSponsored Events
Facial ScrubsRecommended Facial ProductsCleanserTonerMaskEye CreamMoisturizerCotton Tipped ApplicatorsCotton Rounds
Have you been told you have great skills treating nails?
As a makeup artist, do you feel you have a talent/passion for enhancing a persons natural beauty?
Can you provide light make up tips to clients?
Choosing from 1-10. How would you rate you customer service skills when applying makeup to clients, can you course clients through the makeup you are applying and take request confidently.
Do you have a full comfort level of beautifying clients hands and feet (nails)?
Can you perform light hand and feet scrubs in addition to manicure and pedicure sessions?
How many mani’s and or pedis do you feel most comfortable performing in a day?
What is your comfort level with creating nail designs on a scale of 1 - 10?
We comply with many given state laws of not providing manicure and pedicure services from home, Eminence Massage will provide hand and feet massage, & hand and feet scrubs. Files, buffers, coats, color polish, clippers, feet cleansers and nail dryer spray, we will provide no cuticle work.
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Photo (We receive applications every day. It is extremely helpful for us to put your name to a face and know some what how you will present yourself to Eminence Massage Clients. Please attach a photo if available.)
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Do you fully understand your right to refuse mobile spa treatments in situations such as:
Certification: I hereby certify, under the penalty of perjury that the information herein and/or attached is true and correct. I understand that providing false information or with holding information, are grounds for immediate termination of contract.