Course Registration Form

Weave Drs Apothecary

12138 Central Ave #221 Bowie Md 20721

www.maneattractionshair.com

Chelsea.y.mitchell@gmail.com

703.973 7146
Registration Form

Fill out the form carefully for registration
Student Name

First NameMiddle NameLast Name
Birth Date

MonthDayYear
Gender
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Student E-mail
example@example.com
Mobile Number
Format: (000) 000-0000.
Phone Number
Format: (000) 000-0000.
Work Number
Format: (000) 000-0000.
Company
Courses
Additional Comments
How long have you been styling hair?
Are You a licensed Cosmetologist?
Do you have experience applying wigs?
Do you know how to Cornrow?
Hope many social media followers do you have for your business?
Hope many years have you been in business?
I UNDERSTAND that course delivery and retention is solely based on each student. Ask sales are final no refunds. You release mane Attractions free from all liability Signature
Should be Empty: