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City of Rosevit le Minnesot0 . -V i ppist Lplication for Massage cense <br />Please type or print', in ink. <br />2. Home Address A_ <br />Home Telephone <br />4. Business Address <br />5. Business Telephone <br />6., Date of Birth <br />7. Place of Birth, <br />8. Are you an U.S. citiZen? Yes No <br />Naturalized? Yes No If Yes, give date and place. <br />dates and pla,c�es where usied. <br />10. Name and aiddress of the Hicensied Massage, Therapy Establishment that you expect <br />to be employed, by. <br />5 <br />