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ca.gov ESTHETICIAN PRE-APPLICATION FOR EXAMINATION AND INITIAL LICENSE FEE $124.00 (non-refundable) Cashiering Use Only: Cashiering (Entity #) Cashiering (Receipt) Cashiering (Amount) $ SECTION A: APPLICANT INFORMATION Social Security Number Date of Birth (Must be at least 17 years old) - - - - Month Day (Please include a copy of your government-issued photographic identification with this application.) Last Name (Print Clearly) First Name Year Middle Name Note: Double check.

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