Esthetician Certification - New Membership Application

Medical Esthetician Application for Membership

New Membership Application
Date *

Month Day Year
Date
Name *

First Name Last Name
Address: *

Street Address

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City State / Province

Postal / Zip Code Country
E-mail *
Phone Number: *

Area Code Phone Number

1) As a member to GAP, I agree to use new pre-packaged items per procedure at all times. *
Please initial
2) I have read the GAP Membership Guidelines and agree to all terms of the conditions. *
Please initial
3) As a member, I understand that I am a professional and agree to be current on my professional liability insurance at all times. *
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4) I agree to maintain strict sanitation at all times *
Please initial
5) I will promote our mission to safe practice and higher education training. *
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6) I will encourage GAP Certification and never talk bad about GAP Certification. I understand the Association is made up of Committees that are professionals in the industry and decisions and changes are based on the best of knowledge and practice. I hold GAP harmless of any and all liability at all times. *
Please initial
7) I understand GAP is an Association for Certified Professionals and there are no guarantees. *
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8) I understand GAP is not responsible at anytime for my practice, procedures, business success, or any services I provide. I hold GAP harmless and take full responsibility for my actions. I further will protect GAP at all costs. *
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9) All members agree to only use professional products that approved by their insurance companies and will follow the manufacturer’s instructions at all times. *
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10) All members and their employees and contract laborers will utilize safe practices of OSHA sanitation and hospital regulation guideline sanitation (refer to your state board of health). *
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11) I understand in the event I receive a formal complaint from a customer, as a professional I will contact the client and attempt to resolve the complaint within 3 days of the written notice. As a professional I agree to be understanding, sympathetic, patient, and to always maintain a professional conversation. *
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12) All members agree that if they are not a licensed physician or other medical professional, they may not prescribe, suggest, or assist in diagnosing any condition or prescribing any medications. They will protect the client’s confidential information at all times. *
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13) I give permission for my name to be listed on the website as a Certified Professional. *
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I have read and agree to the above and to all items stated in the GAP Certification Guidelines. I agree to indemnify and hold harmless GAP from any loss and expense as a result, but limited to, of any claim or loss arising from my activities. I understand this is not a license, this is a certification from Global Association of Professionals awarded by the committee of professionals in the industry that you will be a part of to protect the image and industry standards. *
Please type your name

Membership Options *

Certified Medical Esthetician (ME) $ 200.00

Professional Listing on GAP Website (one-time fee) $ 200.00

Donations Are Appreciated!

Suggested Donations	Quantity	Price
Option 1		$ 5.00
Option 2		$ 10.00
Option 3		$ 50.00
Option 4		$ 100.00

Item subtotal: $ 0.00

Enter coupon

Total $ 0.00

I understand the application fee of $200 is non-refundable for each Certification. All applications are reviewed by one or more committee members for approval. I give GAP permission to verify all information submitted and testify that all information is true to the best of my knowledge. I further understand that if the application is approved, I will have to take an exam to achieve certification. I understand that the exam fee is $100 and I have 2 tries to pass the exam. I have the option of taking a prep-course for the exam for an additional $200.
By clicking the "Pay Now" button you are submiting your online application and will be re-directed to Paypal to submit your payment. Once we recieve your payment, we will contact you about your Membership.

Thank you!
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Medical Esthetician Application for Membership