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Applicant/Billing Information

Full Name

Mobil Number

Date of Birth

Address

Street Address

City

State

Zip Code

Current Employment information

Company

Phone

Date of Birth

Address

Street Address

City

State

Zip Code

Job Title

Supervisor

License Information

You must have a current Cosmetology Operator license in order to apply for 300 hr Crossover Program. Enter "NA" if you are
applying for the 1000 hr Class A Barber program.

Cosmetology Operator #*

Cosmetology School Attended*

Expiration Date:*

Disclaimer and Signature

Type Your Signature*

I certify that my answers are true and complete to the best of my knowledge.

CODE (if applicable)

Payment Information

Application Fee for BBI

Price: $75.00

A non-refundable $75.00 application fee, payable to Brighton Barber Institute, must accompany your application. No application is processed without payment of the application fee. BBI accepts cash, checks, Visa, MasterCard or payment(s),

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