Name *

First Name

Last Name

Phone *

(###)

###

####

If Currently in School Have You Completed a Minimum of 300 Hours?

Yes

No

What Type of License Do You Have? *

Cosmetologist

Esthetician

Student Enrolled Pursuing License

None

Are You Licensed in South Carolina? *

Yes

No

Are You Certified in Lash Extensions? *

Classic

Volume

Neither

Where Do You Lash? *

Home

Salon/Spa

Not Lashing Currently

Other

How Did You Hear About Venice Lash Academy? *

Facebook/Instagram

Google

Friend

Other

Which Class Are You Interested In? *

All Classes are either Volume or Classic with a max capacity of 6. We will offer a discount to parties that book in groups of 6.

Classic

Volume

Group (6 Max.)

Referred By:

Venice Lash Employee

Friend

Other