BC Academy of Medical Aesthetics & Skin Care

BC Academy of Medical Aesthetics & Skin Care

Training Programs Registration Form

Full Name

First NameLast Name

Phone Number

Area CodePhone Number

E-mail

Current Occupation:

Job Title

Your role or position at work

College License No.: (if applicable)

Required for enrollment in Injectable courses

Include App No. (if any):

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

Residency Status

English Language Proficiency

Course(s) you are enrolling for:

Choose at least one:

Course Date:

MonthDayYear

Method of Payment

If paying by E-transfer please send your payment to: vancouver.bcamas@gmail.com

Type of CC

Name on CC

CC Number:

CC Expiry Date

CC 3-Digit Code

on the back of CC

Comment / Request:

File Attachment

Upload a File

Terms and Conditions

The Applicant consents that the BC Academy of Medical Aesthetics to use the Applicant’s personal information for the purpose of determining eligibility and acceptance criteria. We do not sell, disclose or share your personal and payment information provided here.
The Applicant authorizes the verification of the information contained in this application and information obtained from personal references if applicable.
In the event that this application is not accepted, any payment submitted by the Applicant shall be returned.
Cancellations are accepted no more than 7 business days prior to the course start date. Cancellation is subjected to $50 - $200 processing and administration fee depending on the course fee and duration.
By submitting this form, the Applicant represents that all statements made above are true and correct.

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Please Check applicable boxes:

I agree with the terms and conditionsI do not agree with the terms and conditionsI certify the information I provided is true and accurate

Signature

Taxes and course material are included.