**This information will only be used for our NACCAS report and will NOT be shared/used for any other purpose.
First Name
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Last Name
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Phone
*
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Email
*
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Address
*
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City
*
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State
*
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Postal code
*
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Did you receive your cosmetology (Esthetician, Nail Technician) license?
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Yes
No
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Did you sit for both parts of State Boards?
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Yes, Both Practical & Theory
Only Practical
Only Theory
I have not taken either part of the exam.
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Do you currently work in a salon, nail salon, spa, make-up counter, or a cosmetology store(Sallys, CosmoProf, etc.)? If yes, please tell us the name, address, and phone number of your employer.
*
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Upload a photo of your Cosmetology license.
Did you previously work for a salon, spa, nail salon, make-up counter, or a cosmetology store? If yes, please tell us the name, address, and phone number of your employer. If only 1 day it Matters!
*
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If you work in your home or is self-employed in the beauty field please upload your state driving licenses or state ID.
Are you currently working from home? *Even if you are only providing services to family and friends and charging them a small fee, we consider you working in the field.
*
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Do you need our help with job placement?
*
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Signature
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