(A) The application for a massagist business permit shall be made to the township in the same manner as provided above for massage establishment licenses, accompanied by the nonrefundable massagist permit fee of $75.
(B) The application shall contain, but not be limited to, the following:
(1) The business address and all telephone numbers where the massagist will practice;
(2) Name and residence address, and all names, nicknames and aliases by which the applicant has been known, including the two previous addresses immediately prior to the present address of the applicant;
(3) Social Security number, driver’s license, if any, and date of birth;
(4) Applicant’s weight, height, color of hair and eyes, and sex;
(5) Written evidence that the applicant is at least 18 years of age;
(6) A complete statement of all convictions of the applicant for any sexual offenses including violations of §§ 3121-27 and 5901-03 of the Pennsylvania Crimes Code (18 Pa.C.S.A. §§ 3121 to 3127 and 5901 to 5903), including the date of convictions, nature of the crimes and place convicted;
(7) The name and address of the recognized school attended, the dates attended and a copy of any diploma, certification or letter of recognition of attendance;
(8) The massage or similar business history and experience (ten years) prior to the date of application, including, but not limited to, whether or not such person in previously operating in this or another township or state under license or permit has had such license or permit denied, revoked or suspended and the reasons therefor, and the business activities or occupations subsequent to such action of denial, suspension or revocation;
(9) A medical certificate signed by a physician, licensed to practice in the state, within seven days of the date of the application. The certificate shall state that the applicant was examined by the certified physician and that the applicant is free of communicable disease;
(10) Authorization for the township, its agents and employees to seek information and conduct an investigation into the truth of the statements set forth in the application and the qualifications of the applicant for the permit; and
(11) Written declaration by the applicant, under penalty of perjury, that the foregoing information contained in the application is true and correct, said declaration being duly dated and signed in the township.
(Ord. 160, passed 11-9-2010) Penalty, see § 111.99