Facial & Chemical Peels

Laser/IPL Hair Removal

Laser/IPL Specialist

Microneedling

Microdermabrasion

Microblading

Medical Aesthetics Program

Same address as applicant

If the emergency contact's address is different from the applicant's, please list it here:

Do you have or experience any health issues or medical concerns that could impact your training? (If yes, please explain):

How did you hear about GLAM Group Canada?

When did you first become interested in these types of certifications?

Have you ever been enrolled in a medical aesthetics and/or aesthetics course?

Yes

If yes, please list the course name and school:

High School:

City, Province/State:

Year Graduated:

Grade Point Average:

Other college(s), universities or extended education attended since high school:

School:

City, Province/State:

Major/Course:

Year Graduated:

School:

City, Province/State:

Major/Course:

Year Graduated:

Company:

Phone Number:

Start Date:

Employer Name:

Position:

End Date:

Company:

Phone Number:

Start Date:

Employer Name:

Position:

End Date:

I certify that all statements on this application are true and complete.

I understand that my application will not be considered complete without the applicable registration fees paid.