Fill out the Enrollment Application form below, print and bring with you.

Date:__________________                       Referred by:__________________

First Name:_________________________ Last Name: _____________________

Telephone: ______________Cell: _______________  Email Address: ___________________

Address: _________________________________________

City: ____________________ State: _____________ Zip Code: __________

Age: __________ Work Shop: ___________________

Circle Your Workshop Interest: 

Braiding Certification

Hair Wrapping Certification

HIV/AIDS

Hands on: Braiding

Hands on: Hair Extension/Weaving

Hair Cutting

Makeup Application

Nails