(A) Every application for the privilege license to operate as a massage therapist or a massage therapy establishment shall be upon a form supplied by the Town Clerk and filed with the Town Clerk.
(B) The application shall be made under oath and shall contain the following information:
(1) Massage therapist:
(a) The name, date of birth and residence address of the applicant;
(b) A complete statement of the previous businesses or occupations of the applicant for the five years immediately preceding the date of the application;
(c) The date and place of applicant's birth and the residence address of the applicant for the three years immediately preceding the date of the application;
(d) A complete statement of all convictions of the applicant for any felonies, or for violation of any law or ordinance of any governmental unit concerning or related to the business or profession of massage therapy, or for any offense involving sexual misconduct, whether in this town or any other, including, without limitation, prostitution and offenses against public morality and decency;
(e) A complete statement of any revocation of any license granted by any governmental unit to the applicant to engage in the business or profession of massage therapy; and
(f) Demonstration of competence by means of one of the following:
1. Attachment of a certificate of graduation from a massage therapy school which is either licensed by the State Board of Community Colleges or exempted from licensure;
2. Attachment of a certificate of graduation from a school or institute of massage therapy which offers a minimum curriculum of 500 hours of classroom instruction, and is licensed by an equivalent licensing authority of another state; or
3. Attachment of a certificate of successful examination from the National Certification Board for Therapeutic Massage (NCBTM).
(2) Massage therapy establishments:
(a) If the applicant is an individual, the name, age and residence address of the person; if the applicant is a partnership, corporation or association, the name and residence address of all principals, directors and officers of the partnership, corporation or association, including the name and residence address of any persons having a legal or beneficial ownership interest in the proposed massage therapy establishment;
(b) The address of the premises where the proposed massage therapy establishment shall be located;
(c) A complete statement of all convictions of any person whose name is required to be given in division (B)(2)(a) above for any offense as set out in division (B)(1)(e) above;
(d) A complete statement of any revocation, by any governmental unit, of any license to operate a massage therapy establishment or to engage in the business or profession of massage therapy held by any person whose name is required to be given in division (B)(2)(a) above; and
(e) The name and address of any other establishment or business owned or operated by any person whose name is required to be given in division (B)(2)(a) above, wherein the business or profession of massage is practiced.
(Ord. passed - -, § 14-192)