Honolulu Registration Form 2022

Name preference for certificate *

First Name Last Name

Email

example@example.com

Text Cell#

Area Code Phone Number

2nd person for train with a friend promotion Name preference for certificate

First Name Last Name

E-mail

Text cell #

Area Code Phone Number

How did you find us? *

I will process my payment: *

Cash - I will set up an appointment to in pay full - cash in person prior to the deadline listed. Pay in full via Charge/Debit bottom of page Non refundable prepayment $300.00 to hold my seat balance to paid with via installment of equal amounts every 2 weeks to be paid in full 2 weeks prior to 1st day of training.

I understand I need to be licensed to offer eyelash extension services to the public.

yes

I understand I need to a licensed Esthetician, cosmetologist or current student of either to take the lash lift & tint training *

yes

I do not intend to and understand I am not allowed to train or share any material I wilL receive for my workshop at EEH. I honor and respect EEH & my trainer Karen-Marie request. *

Yes

I am a licensed *

Cosmetologist Esthetician Esthetician, Cosmetologist or Barber Student I am planning to achieve my license I am a current Esthetician or Cosmetologist Student This is for personal information

Online Training: My schedule allows me to complete a tasks list no later then 1 day prior to training date. The link and password will be sent once my payment is paid in full. I have printer to print hard copies required for training. Also wi-fi and a computer (phone or ipad is not acceptable) and a quite space with no distractions for my zoom online training

yes

I understand for in house training my model and self must be present a completed vaccine certificate or of proof negative covid test 48 hours per training session and masked during the complete training. *

yes Not needed as I am taking the online trainning

Due to the Covid Delta Variant. I understand A valid Vaccine Certificate is required for myself and model and

Yes I want to train on my model I am taking the in person and prefer not to bring a model by choice at the same price. I will continue on my own with continued support via text with my trainer. I do have the option to book a private in person hands on training when I'm comfortable working around Covid Precautions. Not needed as I am taking the online training

I understand I will need to complete tasks and homework assignments for certification and my personal schedule allows appropriate time. *

yes

I understand all workshops will teach me the basics. I know I will need to make the time to practice and make what I've learned my own. I will allow time to perfect my new skill before working on clients. *

yes

I understand Private Training Dates will need to be worked with Trainers availability, Tuesday - Saturdays 11:00 am start. I am flexible with dates and times. *

Yes

I understand I will need to be responsible to find my own model for in person training *

Yes Im registering for in person training No Im registering for online training

I am signing up for private training. My request is listed above and will await for approval

I know my preference

I understand I will be responsible for parking fees for myself and model and will read and understand all follow up emails regarding workshops. *

yes

Online training only: I request my kit

To be shipped approx Oahu $20.00 Oahu off island $50.00 or less I will be invoiced for exact amount Pick up at 1188 Bishop Street Location of training

Online trainees only. Please ship my to the following address:

I understand the refund policy: Refund Policies Class Booking fees and payments. All workshop are non-refundable and non-transferable. Meaning the funds cannot be refunded or transferred to another person. *

yes

My Training requests:

Private online Private in person Group in person Module 1&2 bundle Module 3 Online Share Online Share In person

Please list if not above:

Your training: *

Module 3 Online private Mega Fans and Lash Designing $ 300.00

January Promotion with any Bundle.Select training dates between January - June 25 2022 11:00 am start time Cat EyeDolly DesignSquirrel/Kitten Wispy Spiker Design Universal Mega Perfect Line Mega Spiked Mega Textured Mega completed Module 1 & 2 or 3 months hands on volume lashing required.or clearance from instructor.

January Promotion Online Bundle Module 1 & 2 Share with your friend $670.00 each $ 1,350.00

Classic and Volume Fan Development & Hybrid Lash MappingIncludes your fully-loaded kit.Select training dates between January and March 25, 2022 11:0.0 am start time

January Promotion Online Live Module 1 & 2 Bundle - Private $ 895.00

Classic and Volume Fan Development & Hybrid Lash Mapping. Includes your fully-loaded kit. Select training dates between December - June 25, 2022. 11:00 am start time

January Promotion In Person Bundle Module 1 & 2 Private $ 1,200.00

Classic and Volume Fan Development & Hybrid Lash Mapping Includes your fully-loaded kit. Select training dates between January - June 25, 2022. 11:00 am start time 11:00 am start time

January Promotion In Person Share Bundle Module 1 & 2 Share with your friend $895.00 each $ 1,790.00

Classic and Volume Fan Development & Hybrid Lash Mapping Includes your fully-loaded kit. Select training dates between January - June 25, 2022. 11:00 am start time

January Promotion In Person Group Bundle 1&2 $ 995.00

April 15, 16, 30 2022, Module 1 &2 Bundle Classic and Volume Fan Development & Hybrid Lash Mapping includes your fully-loaded kit.

January Promotion In Person Group Bundle 1&2 $ 995.00

May 20, 21, 28 2022 Classic and Volume Fan Development & Hybrid Lash MappingIncludes your fully-loaded kit.

January Promotion In Person Group Bundle 1&2 $ 995.00

Jne 17, 18, 25 2022 Classic and Volume Fan Development & Hybrid Lash MappingIncludes your fully-loaded kit.

In Person Brow Lamination Private $ 775.00

In Person Lash Lift & Tint Private $ 775.00

In Person Lash Lift & Tint and Brow Lamination Private $ 875.00

Online Lash Lift & Tint Private $ 675.00

On line Brow Lamination Private $ 575.00

Online Lash Lift & Tint & Brow Lamination Private $ 875.00

Partial payment to hold my seat $ 300.00

Non refundable partial payment $300.00 Deducted from total due less tax) to hold my seat (kit not included till balance paid in full.) Balance paid with via installments of equal amounts every 2 -3 weeks to be paid in full 2 weeks prior to 1st day of training.

Enter coupon

Subtotal $ 0.00 Tax $ 0.00 Total $ 0.00

Payment Method

Credit Card
First Name	Last Name
Credit Card Number	Security Code
Expiration Month	Expiration Year
Billing Address
Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

Signature: I understand and honor the information above

Clear

Signature of 2nd person for train with a friend promotion: I understand and honor the information above

Clear

I am under age and have my mother's consent listed is my Mother's information.
First Name Last Name Date
Cell Number

Signature: I am under age. I have my Mother's consent to partake in training listed. Her signature below acknowledging the registration form has been read and understood.

Clear

Please verify that you are human *

EYELASH EXTENSIONS HAWAII ACADEMY CERTIFIED TRAINING