Esthetician Registration Form

Please take a moment to fill out the form.

First Name

Last Name

Phone

Gmail Email

Select an Address

Birthday

Social Security Number

Emergency Contact

Relation to student

Emergency Contact Phone Number

Current Employer

Current Work Hours

Interested in Part time or Full time

Year of Diploma (Not Required)

Highest Level of Education

Have you ever been convicted of an offense other than a minor traffic violation? If yes, please provide an explanation including the nature of the offense and action taken. The LBL Beauty Academy asks for full disclosure as this incident could result in licensing denial. The information is kept in the student confidential file.

By registering with The LBL Beauty Academy, I realize that I'm enrolling in a TDLR Approved Lash & Esthetician Beauty Academy. I have been given an understanding of the tuition. I also realize that I'm responsible for my education in attending theory classes and practical requirements to be successful in my program. I will commit to completing written and practical exams as well as the required hours to complete my program.

Your Signature

After you complete the form, click submit

Thanks for submitting!

Once your form is submitted, select pay Enrollment Fee