Tuesday, 06 January 2009
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First Name *
Last Name *
Address *
AppartmentNumber
City *
Province *
Home Phone *
Business Name
Business Phone
Postal Code *
Date of Birth *
Email *
Are you left or right handed? *
Left
Right
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Education
Program
Cosmetology
Advanced Esthetics
Artificial Hair Wefts and Extensions
Make-up Artistry
Artificial Nails
Please register me for my program(s) of choice.
I would like more info on my program(s) of choice.
Highest School Grade Completed: *
Year of Completion: *
Post Secondary Education:
Are you able to come in for an interview?
Yes
No
Approximate enrollment date: *
_______________________________________________________________________________________
If registering, a non-refundable fee of $75 is required. Please make cheques payable to Richards Beauty College. Credit card payments are subject to an additional $1 fee.
Secret word: *