PLEASE SEND ONE ORIGINAL APPLICATION AND SEVEN COPIES Curriculum: Barber Cosmetology Esthetics Manicure Natural Hair Stylist Waxing Name of Proposed School: _______________________________________________________________________ Address of Proposed School: _____________________________________________________________________ Street address County ______________________________________________________________________ City State Zip Code Mailing Address if different: ________________________________________________________________________ Contact Person: ______________________________________ Proposed Opening Date: _____________________ Telephone numbers (please provide two): _____________________________ _______________________________ area code & phone number area code & phone number Day School ________ Night School ________ Both _________ Email: ________________________________ Name and home address of school owner(s): ____________________________________________________________ ________________________________________________________________________________________________ If owner is a corporation, state names and address of officers and principle stockholders and the name of the registered agent (use additional page is necessary): ________________________________________________________________________________________________ ________________________________________________________________________________________________ BY MY SIGNATURE I CERTIFY UNDER PENALTY OF PROSECUTION THAT I AM EITHER A CITIZEN OF THE UNITED STATES OR LEGALLY PRESENT IN THE UNITED STATES AND AUTHORIZED TO WORK.__________________________________________公理我的委员会到期__________________。__________________________________________________________________________________________________所有者的签名所有者的签名__________________________________________________________________________________________________________________________________________多达20。