APPLICATION FOR
COSMETOLOGY APPRENTICE
GEORGIA STATE BOARD OF COSMETOLOGY
237 Coliseum Drive
Macon, Georgia 31217
Phone (478) 207-2440
www.sos.ga.gov/plb/cosmetology
Please read the instructions carefully and be familiar with the laws and rules governing the practice of cosmetology in the State of Georgia. Visit the website for information: www.sos.ga.gov/plb/cosmetology.
**Important**
The Board cannot process incomplete applications. If any item is missing, incomplete, or incorrect, your application cannot be reviewed by the Board. Please review this application before you submit it to ensure that all information and documentation is complete and correct. Incomplete applications result in delayed processing. Incomplete applications are void after one year. Furthermore, because application information is time sensitive, documents cannot be transferred from old applications to new applications.
Application Checklist
The following checklist is an important part of your application. Please use this checklist to ensure that you submit a COMPLETE application.
NON-REFUNDABLE APPLICATION FEE: $45 – Cosmetology Apprentice
The payment must be made by check or money order payable to the Georgia State Board of Cosmetology. DO NOT SEND CASH OR COUNTER CHECKS. Checks returned for insufficient funds are subject to a $40.00 service charge pursuant to O.C. G.A. § 16-9-20.
CITIZENSHIP/QUALIFIED ALIEN STATUS: Please submit a copy of your current Secure and
Verifiable Document(s) such as driver’s license, passport, or document as indicated on pages 22 & 23 of this application.
NOTARIZED APPLICATION: The complete application must be mailed to the Board’s office at the address listed above, along with your FEE. Sign the application in the presence of a notary.
Copy of current shop license and master license are attached
Letter from master releasing previous apprentice (if applicable)
If the master under whom you are training has previously trained an apprentice, our records must indicate that they are no longer training that person. If a master has not notified us that he or she is no longer training an apprentice, he or she must notify us in writing. Without this notification, your application will be delayed.
SUBMIT APPLICATION IN A 9X12 or LARGER ENVELOPE – Do not staple pages or check/money order. Do not fold pages of the application.
Revision Date July 2012 |
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INSTRUCTIONS FOR THE COSMETOLOGY APPRENTICE APPLICATION
Please read the instructions carefully and be familiar with the Laws and Rules governing the specific area in which you are seeking licensure. Failing to follow these instructions will delay the processing of your application.
Section 1 & 2: This section is to be completed by the applicant, signed and notarized.
Section 3: This section is to be completed by the master licensee who will supervise the apprentice. This section must be signed and notarized. The signature of the master trainer must be legible or the application will be returned. The signature of the master trainer must be signed as it appears on the license.
Failure to do so will result in the application being returned and will cause delay in the processing of the apprentice license.
APPRENTICE REQUIREMENTS:
1.Apprentice training is on-the-job training in a cosmetology salon/shop and under the direct supervision of a licensed master licensee with at least 36 months’ experience.
2.Each master cosmetologist or esthetician, nail technician licensee in a salon/shop may train only one (1) apprentice at a time.
3.Any person at least 17 years of age may qualify to train as an apprentice.
4.Apprentice hours are accumulated according to the actual number of hours of performance and training. Apprentice hours are subtotaled 1st of January, the 1st of April, and the 1st of September. Hours reported will be kept on file by the salon/shop owner or manager for inspector review.
The salon/shop owner and master level trainer are responsible for submitting the apprentice hours after the apprentice has completed the hours or is no longer apprenticing under the current master level trainer.
5.Upon completion of the required hours within the appropriate minimum months of training, it is the apprentice’s responsibility to obtain and submit an application for examination and or licensure. The Master Cosmetologist, Esthetician, Nail Technician and Instructors examinations will be administered only by PSI. You may contact PSI using one of the following:
Via the Internet 24 hours a day at www.psiexams.com.
Using a touch-tone phone, call PSI 24 hours a day at (800) 733-9267.
With a PSI registrar at (800) 733-9267, available Monday through Friday, between 7:30 am and 8:00 pm and Saturday, between 11:00 am and 5:00 pm, Eastern Time.
Contact PSI about the examinations, fees, dates, locations, exam content and grade notifications.
CREDIT FOR TRAINING HOURS BEGINS WHEN THE APPRENTICE LICENSE IS ISSUED, NOT WHEN THE APPLICATION IS MAILED TO THE BOARD OFFICE.
APPRENTICE TRAINING:
1.The apprentice will receive a certificate of registration for a period of two (2) years. The certificate may be renewed at the end of such period by renewing the license online via the Board’s website at www.sos.ga.gov and submitting the applicable renewal fee by the expiration date. The renewal fee increases if submitted after the expiration date of the apprentice license. If the apprentice is changing a master supervisor, or salon location, or if the salon where the apprentice has a change in its license status, the apprentice must submit a shop change application.
2.Upon the expiration of the last certificate of registration issued, such person shall not be permitted to practice the occupation in any way until he or she obtains his or her master cosmetology license.
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CHANGE OF TRAINING: |
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If any of the following occurs during the apprenticeship, a new apprentice application must be filed with the Board office |
and a fee of $45.00 must be submitted with the application – NO EXCEPTIONS: |
Change of Master supervising the apprentice; or |
Apprentice changes to a new salon; or |
If the salon where you are apprenticing changes name, location or ownership causing a new salon license |
number to be issued. |
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COSMETOLOGY APPRENTICESHIP HOURS REQUIRED FOR EXAMINATION: |
COSMETOLOGIST |
--- 3,000 HOURS AND 18 MONTHS OF TRAINING |
HAIR DESIGNER |
--- 2,650 HOURS AND 14 MONTHS OF TRAINING |
ESTHETICIAN |
--- 2,000 HOURS AND 18 MONTHS OF TRAINING |
NAIL TECHINICAN --- 1,050 HOURS AND |
8 MONTHS OF TRAINING |
Revision Date July 2012 |
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GEORGIA STATE BOARD OF COSMETOLOGY 237 Coliseum Drive • Macon, Georgia 31217 • (478) 207-2440
www.sos.ga.gov/plb/cosmetology
Application for Cosmetology Apprentice, Fee $45.00 (non-refundable)
License Type: |
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Cosmetology Apprentice |
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Esthetician Apprentice |
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Nail Technician Apprentice |
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Hair Design Apprentice |
Please check the appropriate box:
Initial Application
Renewal Application ($90.00 late renewal)
Change of Shop or Master Application
Additional License Types (currently or previously issued by the Georgia Professional Licensing Boards):
Method Obtained by:
Applicant is applying for above referenced license to obtain:
( ) Apprentice Training as an apprentice for examination
Name
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First |
Middle |
Last |
Name as shown on records or transcripts |
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(if different) |
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First |
Middle |
Last |
Social Security Number ______-_____-________ Date of Birth ___________
*THIS INFORMATION IS AUTHORIZED TO BE OBTAINED &DISCLOSED TO STATE & FEDERAL AGENCIES PURSUANT TO O.C.G.A. § 19-11-1 & O.C.G.A. § 20-3-295, 42 U.S.C.A. § 551 & 20 U.S.C.A. § 101.
Physical Address
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Number and Street |
Apt. No |
City/State |
Zip |
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P.O. Box not acceptable |
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Mailing Address |
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(If different) |
Number and Street |
Apt. No |
City/State |
Zip |
(If you are granted a license, your name, mailing address and license number become public information and will be posted on the Secretary of State’s website. The mailing address is used for renewal notices, and application
processing)
Telephone Number Day |
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Telephone Number Evening |
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E – Mail |
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Fax Number |
*Acknowledgement of your application will be sent by email. Also, if further information is needed, email is the most efficient way for Board staff to contact you so that your application can be processed in the most efficient manner. Your email address will not be shared with third parties.
Revision Date July 2012 |
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COSMETOLOGY APPRENTICE LICENSE APPLICATION
Section 1 (completed by apprentice) This application will be returned if you do not answer the questions on this page.
Have you ever been convicted of a felony or misdemeanor (other than minor traffic violation) or entered a plea of guilty, nolo contendere or under the “First Offender Act,” or been sanctioned by another board or agency? DUI and DWI are not
minor traffic violations.
Yes No
Have you ever had a license revoked, suspended, or otherwise sanctioned by any professional licensing board or agency, or have you ever been denied issuance of, or pursuant to disciplinary proceedings refused renewal of a license by any professional licensing board or agency in Georgia or any other state?
Yes No
If you answered “Yes” to the question regarding court convictions, you must submit to the Board the following: a) a copy of conviction/sentencing document(s) from the Court before which you were convicted and sentenced, signed by the presiding judge, and showing said conviction and sentence; AND, if applicable, b) a statement (on official letterhead) from your probation / parole officer regarding your current status/completion of any probation / parole. Your application will not be processed until this information is received and reviewed by the
Board.
If you answered “Yes” regarding sanctions from another board, you must request that the licensing board or
agency send a certified copy of the action taken against your license with relevant supporting documents to the
Board’s office. Your application will not be processed until this information is received and reviewed by the Board.
Please check here if you answered yes to the question above and have already submitted the documentation to the Board within the past two years. If you have, it is not necessary to resubmit this information, but new convictions must be submitted.
I understand the following: Hours can only be obtained during the period of time that the apprentice is licensed. If an apprentice changes master supervisor or salon where he/she is apprenticing, a new apprentice application must be submitted. If the salon changes ownership, name or location causing a new license number to be issued, a new apprentice application must be submitted. Hours can only be obtained during the period of time that the apprentice, master and salon license are active. Only one apprentice renewal is allowed.
Yes ________No
Revision Date July 2012 |
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APPLICANT AFFIDAVIT:
I hereby swear and affirm that all information provided in this application is true and correct to the best of my knowledge and belief. I further swear and affirm that I have read and understand the current state laws and rules and regulations of the Georgia State Board of Cosmetology and I agree to abide by these laws and rules, as amended from time to time.
By signing this application, electronically or otherwise, I hereby swear and affirm one of the following to be true and accurate pursuant to O.C.G.A. § 50-36-1:
1) _______ I am a United States citizen 18 years of age or older. Please submit a copy of your current
Secure and Verifiable Document(s) such as driver’s license, passport, or document as indicated on pages 22 & 23 of this application.
2) _______ I am not a United States citizen, but I am a legal permanent resident of the United States 18
years of age or older, or I am a qualified alien or non-immigrant under the Federal Immigration and Nationality Act 18 years of age or older with an alien number issued by the Department of Homeland Security or other federal immigration agency. Please submit a copy of your current immigration document(s) which includes either your Alien number or your I-94 number and, if needed, SEVIS number.
In making the above attestation, I understand that any failure to make full and accurate disclosures may result in disciplinary action by the Georgia State Board of Cosmetology and/or criminal prosecution.
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Signature of ApplicantDate
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Print Applicant’s Name
Personally appeared before me, the undersigned official authorized to administer oaths, comes
_______________________________who deposes and swears that he/she is the person who executed this
(Applicant’s Name)
application for a license by examination for Cosmetology in the State of Georgia; and that all of the statements
herein contained are true to the best of his/her knowledge and belief.
Sworn to and subscribed before me this ______ day of ___________________, 2________
Notary Public Signature ________________________________ |
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County |
State |
My Commission Expires ______________________
(seal)
Revision Date July 2012 |
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