56 N State St
Orem, UT 84057
Are you a licensed massage therapist under the Massage Practice Act?
Will you be performing massage services in Orem?
Will you comply with all applicable federal, state and local law?
Please submit your application now. The portion below will be filled out in-person in the Orem Business Licensing office in the presence of a registered notary public.
If you have any questions about his process, please call Orem Business Licensing at 801-229-7052
Printed Name: ________________________________________
STATE OF UTAH )
COUNTY OF UTAH )
On this _________________ day of ______________________, 20____, personally appeared before me _________________________________, whose idenity is personally known to me or proved to be on the basis of satisfactory evidience, and who executed this document in my presence.