(select all that apply)
Medical Aesthetics/Dermatology Technician
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):
EXTENDED APPLICANT INFORMATION
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?