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Which industry is your business most closely related to?.
Engineering and Architecture
Beauty, Spa, and Aesthetics
Finance, Real Estate
Entertainment
Community Services
Healthcare and Wellness
Protection and Security Services
Tattoo, Ear Piercing
Technology
Property
Restaurants and food services
Sports & Fitness
Legal Services
Other
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Please describe:
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Please enter your gross revenue for the past 12 months: $
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Please enter the legal name of your company (not trade name):
(*)
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Are you a certified professional for the services you do?
Yes
No
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Please enter the type of your company:
Corporation
Professional LLC
Non-Profit
Partnership
Trust
Individual / Sole Proprietor
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Number of full time personnel including owners:
(*)
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Number of part time personnel (less than 2 days per week):
(*)
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Please select the services you provided:
Acid/chemical peels
Acupuncture or acupressure
Body massage
Body wraps
Cellulite treatment
Chiropody
Dietician services
Ear candling
Electrical heat or steam baths
Electrolysis
Energy healing
Eye lash extensions/perms
Eyebrow tinting
Eyelash tinting
Face lifting/plastic surgery
Facial treatments
Hair care services
Hair removal
Hormone treatment
Hydrotherapy
Injections (any kind)
Laser treatments
Make-up (non-permanent)
Make-up (permanent or tattoo)
Manicures/pedicures
Microdermabrasion
Muscle toning
Piercing (other than nose or ears)
Reiki, reflexology, or aromatherapy
Removal of warts, moles, or growths
Saunas
Sculptured nails
Skin rejuvenation
Tanning
Tattoo removal
Vein treatment
Other
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Please enter your treatment:
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Has there been any claims, accidents or injury in the last 10 years?
Yes
No
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Please describe the situation:
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How many years have you been in this location:
(*)
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How many years have you been in this industry?:
(*)
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Please list the values of any tools and equipment you use (if any):
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Please fill out the following information below
Applicant Full Name:
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Please enter your full name.
Phone Number
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E-mail
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Address 1:
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Please tell us your address
Address 2:
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Postal Code:
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