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Get Kansas Board Of Cosmetology Form

Mail the completed form and apprentice license to Kansas Board of Cosmetology 714 SW Jackson Suite 100 Topeka Ks 66603-3751. KANSAS BOARD OF COSMETOLOGY NOTICE OF COMPLETION COSMETOLOGY INSTRUCTIONS 1. This form is to be completed in its entirety for any apprentice who has discontinued training or graduated. 2. Upon payment of all said contractual fees and/or completion of all assignments a Notice of Training Completion shall be submitted to the Kansas Board of Cosmetology within 10 days of said completion. It is understood that the above-named apprentice will not be eligible for examination in the state of Kansas until all contractual requirements have been met and required certification has been submitted. CERTIFICATION I DECLARE UNDER PENALTY OF PERJURY IN THE STATE OF KANSAS THAT THE INFORMATION PROVIDED IS TRUE AND CORRECT SIGNATURE OF SCHOOL OWNER OR AUTHORIZED AGENT Revised July 2012 DATE NAME AND ADDRESS OF SCHOOL Disclosure is mandatory for licensure and authorized by KSA 74-148 used to verify identity and license individuals lawfully residing in the US.. If only reporting that an apprentice has met all contractual requirements complete the following sections Apprentice Personal Data Contractual Information and Certification* 3. APPRENTICE PERSONAL DATA All information must be typed APPRENTICE NAME LAST FIRST MIDDLE APPRENTICE SOCIAL SECURITY NUMBER APPRENTICE ADDRESS STREET CITY STATE ZIP SCHOOL NAME AND ADDRESS TRAINING START DATE DATE OF APPRENTICE TERMINATION OR GRADUATION TRAINING INFORMATION LIST TOTAL ACCUMULATED HOURS FOR ABOVE-NAMED APPRENTICE IN EACH SUBJECT AREA SUBJECT TOTAL HOURS SCIENTIFIC CONCEPTS BUSINESS PRACTICES PHYSICAL SERVICES STATE LAW CHEMICAL SERVICES STUDENT SPECIFIC NEEDS HAIR DESIGNING CONTRACTUAL INFORMATION TOTAL SUBJECT HOURS Check one This document certifies that the above-named apprentice entered into a contract with this school* All contractual fees have been paid and all assignments have been completed* Therefore all hours are being released for inclusion toward the 1500 hours required for licensure pursuant to K. S*A. 65-1903. The apprentice has not paid all contractual fees to this school and/or completed all assignments. APPRENTICE PERSONAL DATA All information must be typed APPRENTICE NAME LAST FIRST MIDDLE APPRENTICE SOCIAL SECURITY NUMBER APPRENTICE ADDRESS STREET CITY STATE ZIP SCHOOL NAME AND ADDRESS TRAINING START DATE DATE OF APPRENTICE TERMINATION OR GRADUATION TRAINING INFORMATION LIST TOTAL ACCUMULATED HOURS FOR ABOVE-NAMED APPRENTICE IN EACH SUBJECT AREA SUBJECT TOTAL HOURS SCIENTIFIC CONCEPTS BUSINESS PRACTICES PHYSICAL SERVICES STATE LAW CHEMICAL SERVICES STUDENT SPECIFIC NEEDS HAIR DESIGNING CONTRACTUAL INFORMATION TOTAL SUBJECT HOURS Check one This document certifies that the above-named apprentice entered into a contract with this school* All contractual fees have been paid and all assignments have been completed* Therefore all hours are being released for inclusion toward the 1500 hours required for licensure pursuant to K. S*A. 65-1903. The apprentice has not paid all contractual fees to this school and/or completed all assignments.

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