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First Name *

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Company Name *

Dept/Mail Stop

Address *

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What is your primary business? * 


Your job title: * 


Which services does your salon/spa offer to clients? 

  • Haircut and styling
  • Hair color
  • Straightening
  • Perming/chemical services
  • Blowout services
  • Hair Extensions
  • Men's Services
  • Lashes
  • Brows
  • Nails
  • Facials
  • Body Services
  • Massage
  • Waxing
  • Scalp treatments
  • Hair Loss
  • Makeup application
  • Tanning
  • Other
  • Not Applicable

Which professional Cosmetology licenses do you currently hold? 

  • Cosmetologist
  • Nail Technician
  • Esthetician
  • Barber
  • Massage Therapist
  • Other
  • No active state license

Is your salon or spa independent or part of a chain? 

  • Independent
  • Chain

Are you a booth renter? 

  • Yes
  • No

Number of nail technicians at this location:

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