Be A Model DCCM Form

BE A MODEL with DCCM™

Thank you for your interest in becoming a model for educational purposes with DCCM™ Academy
All treatments are performed by licensed professionals while our Master Injector and owner diligently oversees the placement of each injection.

We offer Neurotoxin (Botox, Dysport, Xeomin) training on the first Thursday of every month.

&

Dermal Filler (Allergan, and Galderma) training the second Thursday of every month.

If you would like to be considered a candidate to become a model please submit the following information along with photos.
Name:*

First NameLast Name
Email:*
example@example.com
Date of Birth:*

MonthDayYear
Date
Phone Number*
Please enter a valid phone number.
Your Interest:*

Interested in BotoxInterested in Dermal filler
There is a $100 injection fee for all Neurotoxin models and a $150 Injection fee for all dermal filler models.

Please note that there are NO refunds on the deposit or refunds after treatment. Models are an integral part of the students learning and therefore must commit to the treatment.
Photos:

Please attach makeup-free photos of yourself.

Please follow these guidelines while taking your photos:

-Remove all makeup and tie your hair back including your bangs.

-Stand in front of a blank wall.

-Turn off the flash on your camera.

-Look straight ahead and maintain a relaxed, neutral expression.
1. Photo of Front View of your face:*
2. Photo of 3/4 Angle View of your face:*
3. Photo of your Side Profile:*
Should be Empty:

BE A MODEL with DCCM™