Ga Cosmetology Apprentice Form PDF Details

The journey to becoming a cosmetology apprentice in Georgia is a structured one, guided by specific requirements laid out by the Georgia State Board of Cosmetology. To embark on this path, interested individuals must navigate through the meticulously detailed process as outlined in the Application for Cosmetology Apprentice. Located at the heart of this process is the comprehensive application form which serves as the gateway to obtaining a cosmetology apprentice license in Georgia. This critical document, which comes along with a non-refundable application fee of $45, ensures adherence to the state's stringent regulations aiming to maintain high standards within the cosmetology industry. Filling out this form accurately and completely is paramount, as any discrepancies or omissions can significantly delay the application process. The form not only requires personal identification details and a notarized declaration but also necessitates crucial documentation such as proof of citizenship or qualified alien status, a copy of the current shop and master license, and potentially, a letter from a master releasing a previous apprentice. Further, it highlights the importance of following instructions carefully, especially regarding the submission of completed applications to avoid voidance after a year. Additionally, it lays down the apprentice requirements, including the supervision by a licensed master cosmetologist, esthetician, or nail technician with substantial experience, and stipulates the on-the-job training hours necessary for examination eligibility in various cosmetology disciplines. Understanding and adhering to these stipulations, including the application checklist, can ultimately lead to successful licensure, setting the stage for a rewarding career in the cosmetology field in Georgia.

QuestionAnswer
Form NameGa Cosmetology Apprentice Form
Form Length22 pages
Fillable?No
Fillable fields0
Avg. time to fill out5 min 30 sec
Other namesdeposition vs subpoena, cosmetology apprentice georgia form, apprentice form georgia, cosmetology apprenticeship georgia

Form Preview Example

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 ENVELOPEDo not staple pages or check/money order. Do not fold pages of the application.

Revision Date July 2012

1

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.

CHANGE OF TRAINING:

 

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.

 

 

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

2

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:

 

Cosmetology Apprentice

 

 

 

Esthetician Apprentice

 

 

 

Nail Technician Apprentice

 

 

 

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

 

First

Middle

Last

Name as shown on records or transcripts

 

(if different)

 

 

 

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

 

Number and Street

Apt. No

City/State

Zip

 

P.O. Box not acceptable

 

 

 

Mailing Address

 

 

 

 

(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

 

Telephone Number Evening

 

E – Mail

 

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

3

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

4

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.

_____________________________________________________

Signature of ApplicantDate

_____________________________________________________

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 ________________________________

________________________________

 

County

State

My Commission Expires ______________________

(seal)

Revision Date July 2012

5

Section 2

Name of SALON/SHOP where Apprentice will receive training (ATTACH COPY OF CURRENT LICENSE):

COSMETOLOGY SALON/SHOP NAME - MUST BE EXACTLY AS IT APPEARS ON THE LICENSE

SALON/SHOP PHYSICAL AND MAILING ADDRESS - MUST BE EXACTLY AS IT APPEARS ON THE LICENSE

Salon/Shop License Number

 

 

 

 

 

 

 

 

 

 

 

 

Salon/Shop Telephone Number:

-

 

 

-

 

 

 

 

 

Have you ever previously registered as an apprentice?

 

 

Yes

 

 

No

If YES, When?

 

 

What type of apprenticeship?

 

 

 

 

 

 

 

 

License Number

 

 

Did you complete the apprenticeship? [

] Yes

[ ] No.

Are you currently working under an apprentice license? [

] Yes [ ] No. If YES, give date of license expiration

I UNDERSTAND THAT IN ORDER FOR ME TO QUALIFY FOR THE EXAMINATIONS OFFERED BY THE COSMETOLOGY BOARD, I MUST PROVIDE PROOF OF A HIGH SCHOOL DIPLOMA, OR GED DIPLOMA, OR A POSTSECONDARY EDUCATION, OR COLLEGE DEGREE.

Signature of Apprentice Applicant

Printed Name of Applicant

Sworn to and Subscribed before me on this

 

day of

20

.

 

 

 

 

 

 

 

Notary Signature

NOTARY SEAL

My commission expires on

/

/

Revision Date July 2012

6

Section 3. Questions for the Master Cosmetologist, Hair Designer, Esthetician or Nail Technician

Supervising the Apprentice:

Apprentice Name: _______________________________________________________________

Supervisor Name: _____________________________ License No. ______________________

(for this application)

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

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.

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” 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.

Yes No

Yes No

Yes No

Yes No

Yes No

Yes No

Yes No

Salon/Shop owner or manager or master trainer, are responsible for keeping daily record of apprentice hours.

Salon/Shop owner or manager and master trainer are responsible for apprentice having a thorough understanding of sanitization. Refer to sanitation tip sheet.

Master trainer always monitors apprentice’s sanitation procedure.

Do you have cosmetology books/workbook for apprentice to study?

Do you have the sanitary regulations for apprentice to study?

Do you have the rules of the Georgia Board of Cosmetology for apprentice to study?

Does apprentice have related kit, and all the tools they will need to learn the specific profession in cosmetology?

Yes No I understand the following regarding apprentices: 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 I understand that failure to have apprentice reports and/or records current shall result in a fine of $200.00 (Rules 130-2-.06(2)(a)(b)(c) and 130-7-.04(a)(5).)

Revision Date July 2012

7

Yes No I understand that failure of apprentice to be under direct supervision of their registered master license holder or temporarily designated master license holder shall result in a fine of $500.00 (Rules 130-2-

.06(a)(c), 130-2-.09, 130-4-.06, and 130-7-.04(a)(6).)

APPRENTICE HOURS ARE SUBTOTALED 1ST OF JANUARY, 1ST OF APRIL, AND 1ST OF SEPTEMBER. HOURS REPORTED WILL BE KEPT ON FILE BY SALON/SHOP OWNER OR MANAGER FOR INSPECTOR TO REVIEW.

Apprentice hours are accumulated according to the actual number of hours of performance and training. It is the responsibility of the salon/shop owner and the master to see that an accurate record is kept of the apprentice hours. IT IS NOT THE RESPONSIBILITY OF THE APPRENTICE. It is your responsibility to submit these hours at the end of the apprenticeship or once the apprentice is no longer training with you.

I agree to act as supervising master cosmetologist, nail technician, esthetician or hair designer for the apprentice whose name appears above. I agree to provide direct supervision when the apprentice whose name appears above is working in the salon/shop.

STATE OF GEORGIA

 

COUNTY OF ___________________________________

______________________________________________

 

SIGNATURE OF THE MASTER SUPERVISING THE

 

APPRENTICE

SUBSCRIBED AND SWORN TO BEFORE ME THIS

 

 

______________________________________________

________ DAY OF _____________________, _________

PRINT NAME

_______________________________________________

______________________________________________

NOTARY PUBLIC

DATE

MY COMMISSION EXPIRES: _____________________

 

Revision Date July 2012

8

GEORGIA STATE BOARD OF COSMETOLOGY

237 COLISEUM DRIVE

MACON, GA 31217

TRANSCRIPT OF COSMETOLOGY APPRENTICE TRAINING

It is hereby certified that___________________________________________________

Apprentice Last NameFirst NameMiddle Name

Apprentice License. #__________________________

Salon Name _________________________________ Salon License No.__________________

Completed the following hours from ____________________to___________________

MM/DD/YYYYMM/DD/YYYY

Master Signature __________________________ Master License No. ___________________

Apprentice Signature

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.

 

 

 

 

 

 

 

 

 

COURSES

Hours Completed

 

 

 

 

 

 

 

 

 

 

700 hrs.

 

THEORY in any category one clock hour equals one credit hour

 

 

 

 

 

 

 

 

 

 

 

250 hrs.

 

HAIRCUTTING AND SHAPING 1 haircut =.75 HRS

 

 

 

 

 

 

 

 

1 shampoo =.25 hrs 1 temp rinse =.75 hrs

 

 

 

 

660 hrs.

 

SHAMPOOING HAIRDRESSING & STYLING 1 shampoo &

 

 

 

 

 

 

 

 

style or 1 pressing, curling & comb-out 1.5 hrs

 

 

 

 

250 hrs.

 

HAIR-COLOR OR BLEACHING 1 color including style=2 hrs

 

 

 

 

 

 

 

 

or 1 bleach including style=2.5 hrs

 

 

 

 

360 hrs.

 

PERMANENT 1 cold or heat wave including style = 3 hrs

 

 

 

 

 

 

 

 

SCALP TREATMENT # 1 scalp treatment = 1 hrs

 

 

 

 

250 hrs.

 

FACIALS 1 facial = 1 hrs

 

 

 

 

 

 

 

 

MAKEUP ARCHING ESTHETICS 1 brow & lash

 

 

 

 

 

 

 

 

tint=.5hrs

 

 

 

 

 

 

 

100 hrs.

 

CHARM, RECEPTION, ART & ETHICS, STATE LAWS AND

 

 

 

 

 

 

 

 

BOARD RULES

 

 

 

 

 

 

 

 

 

 

 

 

70 hrs.

 

MANICURE

1 manicure = 1 hrs

 

 

 

 

 

 

 

 

1 sculptured nails application = 3 hrs

 

 

 

 

 

 

 

 

PEDICURE # 1 pedicure = 1 hrs

 

 

 

 

200 hrs.

 

CHEMICAL & RELAXING

 

 

 

 

 

 

 

 

1 chemical relaxer = 2 hrs

 

 

 

 

100 hrs.

 

LABORATORY Training in all chemicals including sanitation one clock hour

 

 

 

 

 

 

 

 

= one credit hour.

 

 

 

 

60 hrs.

 

Additional Instruction

 

 

 

 

 

 

 

 

 

 

 

 

 

3000

 

 

 

TOTAL HOURS

 

 

 

 

HRS.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Sworn to and subscribed before me

 

 

 

 

 

This

 

day of

 

 

20

 

 

 

 

 

 

 

 

 

 

 

 

NOTARY SEAL

Notary Signature

 

 

 

 

My commission expires on

/

/

 

 

 

 

Revision Date July 2012

 

 

 

 

 

9

GEORGIA STATE BOARD OF COSMETOLOGY

237 COLISEUM DRIVE

MACON, GA 31217-3858

HOW TO CHANGE FROM CLOCK HOURS TO CREDIT HOURS

THEORY

An apprentice can study theory in any category for one clock hour and get 1 credit hour.

HAIRCUTTING AND SHAPING

One haircut = .75 of a credit hour.

One shampoo = .25 of a credit hour.

A temp rinse = .75 of a credit hour.

SHAMPOOING HAIRDRESSING AND STYLING

One shampoo and style or one pressing, curling and comb-out= 1.5 credit hours.

HAIR-COLOR OR BLEACHING

One color including style = 2 credit hours.

A bleach including style = 2.5 credit hours

PERMANENT

One cold or heat wave including style = 3 credit hours.

SCALP TREATMENT

One scalp treatment = 1 credit hour.

FACIALS AND MAKE-UP, ARCHING AND ESTHETICS

One facial = 1credit hour.

One brow and lash tint = .5 of a credit hour.

CHARM RECEPTION ART AND ETHICS

One hour learning how to work the desk and how to deal properly with clients for one clock hour = 1 credit hour.

MANICURE AND PEDICURE

One manicure = 1 credit hour.

One pedicure = 1 credit hour.

One sculptured nail application (full set) = 3 credit hours.

CHEMICAL AND RELAXING

One chemical relaxer = 2 credit hours.

LABORATORY

An apprentice will get training in preparing germicidal solutions, shampoos, tint and bleaches, practical training in washing and sanitizing all equipment in the beauty salon each. Each clock hour of this training will be equal to 1 credit hour.

PLEASE NOTE: CREDIT/CLOCK HOURS ARE THE SAME.

Revision Date July 2012

10

GEORGIA STATE BOARD OF COSMETOLOGY

237 COLISEUM DRIVE

MACON, GA 31217-3858

TRANSCRIPT OF HAIR DESIGNER APPRENTICE TRAINING

It is hereby certified that___________________________________________________

Apprentice Last Name

First Name

Middle Name

Apprentice License. #__________________________

 

Salon Name _________________________________ Salon Lic#__________________

Completed the following hours from ____________________to___________________

MM/DD/YYYY

MM/DD/YYYY

Master Signature ____________________________________ Master License No. ___________________

Apprentice Signature

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.

 

 

 

Hours

 

 

 

Courses

Hours

 

 

 

Required

 

 

 

 

Completed

 

 

 

 

 

 

 

 

 

700hrs.

THEORY in any category one clock hour equals one credit hour

 

 

 

 

 

 

 

 

 

 

320 hrs.

HAIRCUTTING AND SHAPING 1 haircut =.75 HRS

 

 

 

 

 

 

1 shampoo =.25 hrs 1 temp rinse =.75 hrs

 

 

 

 

280 hrs.

SHAMPOOING HAIRDRESSING & STYLING 1 shampoo

 

 

 

 

 

 

& style or 1 pressing, curling & comb-out 1.5 hrs

 

 

 

 

350 hrs.

HAIR-COLOR OR BLEACHING 1 color including style=2

 

 

 

 

 

 

hrs or 1 bleach including style=2.5 hrs

 

 

 

 

430 hrs.

PERMANENT 1 cold or heat wave including style = 3 hrs

 

 

 

 

 

 

 

 

 

 

100 hrs.

SCALP TREATMENT # 1 scalp treatment = 1 hrs

 

 

 

 

 

 

 

 

 

 

100 hrs.

CHARM,RECEPTION, ART & ETHICS, STATE LAW AND

 

 

 

 

 

 

BOARD RULES

 

 

 

 

 

 

 

 

 

 

270 hrs.

CHEMICAL & RELAXING

 

 

 

 

 

 

1 chemical relaxer = 2 hrs

 

 

 

 

100 hrs.

LABORATORY Training in all chemicals including sanitation one clock

 

 

 

 

 

 

hour = one credit hour.

 

 

 

2650

 

TOTAL HOURS

 

 

 

 

Hrs.

 

 

 

 

 

 

 

 

 

Sworn to and subscribed before me

 

This

 

 

Day of

 

 

20

 

 

 

Notary Signature

NOTARY SEAL

Revision Date July 2012

11

GEORGIA STATE BOARD OF COSMETOLOGY

237 COLISEUM DRIVE

MACON, GA 31217-3858

HOW TO CHANGE FROM CLOCK HOURS TO CREDIT HOURS

THEORY

An apprentice can study theory in any category for one clock hour and get 1 credit hour.

HAIRCUTTING AND SHAPING

One haircut = .75 of a credit hour.

One shampoo = .25 of a credit hour.

One temp rinse = .75 of a credit hour.

SHAMPOOING HAIRDRESSING AND STYLING

One shampoo and style or one pressing, curling and comb-out it = 1.5 credit hours.

HAIR-COLOR OR BLEACHING

One color including style = 2 credit hours.

One = bleach including style for 2.5 credit hours

PERMANENT

One cold or heat wave including style = 3 credit hours.

SCALP TREATMENT

One scalp treatment = 1 credit hour.

CHARM RECEPTION ART AND ETHICS

One hour learning how to work the desk and how to deal properly with clients for one clock hour = 1 credit hour.

CHEMICAL AND RELAXING

One chemical relaxer = 2 credit hours.

LABORATORY

An apprentice will get training in preparing germicidal solutions, shampoos, tint and bleaches, practical training in washing and sanitizing all equipment in the beauty salon each. Each clock hour of this training will be equal to 1 credit hour.

Revision Date July 2012

12

GEORGIA STATE BOARD OF COSMETOLOGY

237 COLISEUM DRIVE

MACON, GA 31217-3858

TRANSCRIPT OF NAIL CARE APPRENTICE TRAINING

It is hereby certified that___________________________________________________

Apprentice Last NameFirst NameMiddle Name

Apprentice License. #__________________________

Salon Name _________________________________ Salon License No.__________________

Completed the following hours from ____________________to___________________

MM/DD/YYYYMM/DD/YYYY

Master Signature __________________________ Master License No. ___________________

Apprentice Signature

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.

 

 

 

Hours

 

 

 

 

Courses

 

Hours

 

 

 

 

Required

 

 

 

 

 

 

Completed

 

 

 

 

 

 

 

 

 

 

 

 

 

280 hrs.

 

THEORY in any category one clock hour equals one credit hour

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

140 hrs.

 

MANICURE W/ HAND & FOREARM MASSAGE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

20 hrs.

 

ARTIFICIAL NAIL REMOVAL & NAIL REPAIR

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

60 hrs.

 

NAIL FILL IN APPLICATIONS

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

120 hrs.

 

ARTIFICIAL TIP APPLICATION W/OVERLAY

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

40 hrs.

 

NAIL WRAPPING

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

180 hrs.

 

NAIL SCULPTURING

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

120 hrs.

 

PEDICURE W/FOOT AND LEG MASSAGE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

20 hrs.

 

NAIL ARTS TECHNINQUES

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

10 hrs.

 

PROFESSIONAL DRILL USAGE W/DRILL DESIGNS

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

10 hrs.

 

AIR BRUSH NAIL ART

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

10 hrs.

 

PARAFFIN TREATMENTS (HAND & FEET)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

40 hrs.

 

RELATED SUBJECTS AND ADVANCED TECHNIQUES

 

 

 

 

 

 

 

 

 

 

 

 

 

 

1050

 

 

TOTAL HOURS

 

 

 

 

 

 

Hrs.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Sworn to and subscribed before me

 

 

 

 

 

 

This

 

 

Day of

 

 

 

20

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Notary Signature

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

NOTARY SEAL

 

 

My commission expires on

/

/

 

 

 

 

 

Revision Date July 2012

 

 

 

 

 

 

13

GEORGIA STATE BOARD OF COSMETOLOGY

237 COLISEUM DRIVE

MACON, GA 31217-3858

HOW TO CHANGE FROM CLOCK HOURS TO CREDIT HOURS FOR

NAIL CARE APPRENTICES.

THEORY

An apprentice can study theory in any category for one clock hour and get 1 credit hour.

MANICURING

One manicure with hand and a forearm massage = 1 credit hour.

ARTIFICIAL NAILS

Artificial tip application with overlay (gel or acrylic) = 3 credit hours.

One fill in application = 1.5 credit hours.

One set sculptured nails = 3 hours.

Natural nail overlay = 1 credit hour.

One repair and artificial removal = .50 credit hours.

One natural nail wrap (silk or linen) =1 credit hour.

PEDICURE

One pedicure and foot massage = 1 credit hour.

NAIL ARTS AND ETHICS

One clock hour = one credit hour.

RELATED SUBJECTS

Professional nail drill usage = .50 credit hours.

Nail art & airbrush techniques, full set = 1 credit hour.

Hot oil treatment = .50 credit hour.

Paraffin treatment = .50 credit hour.

ADDITIONAL INSTRUCTION

Additional instruction in any category for one clock hour = 1 credit/clock hour.

Revision Date July 2012

14

MM/DD/YYYYMM/DD/YYYY

GEORGIA STATE BOARD OF COSMETOLOGY

237 COLISEUM DRIVE

MACON, GA 31217-3858

TRANSCRIPT OF ESTHETICIAN APPRENTICE TRAINING It is hereby certified that

 

 

Apprentice Last name

First name

Middle

Apprentice License #

 

 

 

 

 

Salon Name

 

 

Salon License No.

 

Completed the following hours from ____________________to___________________

Master Signature___________________________ Master License No. ___________________

Apprentice Signature

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.

 

 

 

Hours

 

 

 

 

Courses

Hours

 

 

 

Required

 

 

 

 

 

Completed

 

 

 

 

 

 

 

 

 

 

300 hrs.

 

PROFESSONAL PRACTICES

 

 

 

 

 

 

 

 

 

 

 

40 hrs.

 

PROFESSIONAL ETHICS

 

 

 

 

 

 

 

 

 

 

 

160 hrs.

 

BUSINESS PRACTICES

 

 

 

 

 

 

 

 

 

 

 

 

 

 

640 hrs.

 

SCIENCES

 

 

 

 

 

 

 

 

 

 

 

 

 

 

150 hrs.

 

BODY TREATMENT

 

 

 

 

 

 

 

 

 

 

 

 

 

 

230 hrs.

 

FACIALS

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

180 hrs.

 

MAKE-UP

 

 

 

 

 

 

 

 

 

 

 

 

 

 

150 hrs.

 

HAIR REMOVAL

 

 

 

 

 

 

 

 

 

 

 

150 hrs.

 

SPA/SALON MANAGEMENT

 

 

 

 

 

 

 

 

 

 

2000

 

 

TOTAL HOURS

 

 

 

 

Hrs.

 

 

 

 

 

 

 

 

 

 

 

 

 

Sworn to and subscribed before me

 

 

 

 

This

 

 

Day of

 

 

 

20

 

 

 

 

 

 

 

 

 

 

 

Notary Signature

 

 

 

 

 

NOTARY SEAL

My commission expires on

/

/

 

 

 

Revision Date July 2012

15

GEORGIA STATE BOARD OF COSMETOLOGY

237 COLISEUM DRIVE

MACON, GA 31217-3858

HOW TO CHANGE FROM CLOCK HOURS TO CREDIT HOURS FOR ESTHETICANS.

THEORY; Professional Practices, Professional Ethics, Business Practices

An apprentice can study theory in any category for one clock hour and get 1 credit hour.

SCIENCES

Sciences, in any category, one clock hour = 1 credit hour.

BODY TREATMENT

One body treatment = 1credit hour.

FACIALS

One facial = 1 credit hour.

MAKE-UP

One make-up = 1 credit hour.

HAIR REMOVAL

One hair removal or waxing (lip, chin, face) = 1 credit hour.

One leg hair removal = 2 credit hours.

One bikini hair removal = .50 credit hours.

One arching = .50 credit hours.

ADDITIONAL INSTRUCTION

One brow and lash tinting = 1 credit hour.

Revision Date July 2012

16

Georgia Board of Cosmetology - Cosmetology Apprentice Daily Log - Month/Year______________

Apprentice license number ____________ Print apprentice name _________________________ Signature of apprentice _________________________

 

Sworn to and subscribed before me

SEAL

Printed Name of Master _____________________________

 

This _______Day of ____________, 20 _____

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Day

Theory

Hair &

Shampooing

Hair

 

Perm. &

 

Facials

Charm

Manicure

Chemical

Lab. I

Additional

Total

 

 

Cutting

Hairdressing

Coloring

 

Scalp

 

Make-

Reception

&

&

 

Instruction

Hours

 

 

 

 

Pedicure

 

 

 

Shaping

Styling

Bleaching

 

Treatments

 

up

Art &

Relaxing

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Esthetics

Ethics,

 

 

 

 

 

1

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

2

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

3

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

4

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

5

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

6

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

7

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

8

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

9

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

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11

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

12

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

13

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

14

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

15

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

16

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

17

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

18

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

19

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

20

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

21

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

22

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

23

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

24

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

25

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

26

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

27

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

28

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

29

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

30

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

31

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Signature of Master ________________________________

 

Signature of Notary _________________________

 

 

 

 

 

 

 

 

 

My commission expires:

 

 

 

 

 

Master License # ____________________________

 

 

Printed name of salon/shop owner or manager:

 

 

 

Signature of Salon/Shop Owner/Mgr:

 

 

 

________________________________________

______________________________________________________________

Revision Date July 2012

17

Georgia Board of Cosmetology Hair Designer Apprentice Daily Log - Month/Year______________

Apprentice license number ____________ Print apprentice name _________________________ Signature of apprentice _________________________

Sworn to and subscribed before me

 

SEAL

Printed Name of Master _____________________________

This _______Day of ____________, 20 _____

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Charm,

 

 

 

 

 

 

Hair &

Shampooing

 

Hair

 

Perm.

Scalp

Reception

Chemical

Lab. I

Total

 

Day

Theory

Cutting

Hairdressing

 

Coloring

 

Treat-

Treat-

Art &

&

 

Hours

 

Styling

 

 

Relaxing

 

 

 

 

Shaping

 

Bleaching

 

ments

ment

ethics,

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

1

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

2

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

3

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

4

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

5

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

6

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

7

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

8

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

9

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

10

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

11

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

12

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

13

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

14

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

15

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

16

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

17

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

18

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

19

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

20

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

21

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

22

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

23

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

24

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

25

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

26

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

27

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

28

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

29

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

30

 

 

 

 

 

 

 

 

 

 

 

 

 

31

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Signature of Master ________________________________

Signature of Notary _________________________

 

 

 

 

 

 

 

 

My commission expires:

 

 

 

 

 

Master License # ____________________________

Printed name of salon/shop owner or manager:

 

 

 

Signature of Salon/Shop Owner/Mgr:

 

 

________________________________________

____________________________________________________________

Revision Date July 2012

18

Georgia Board of Cosmetology Nail Technician Apprentice Daily Log- Month/Year______________

Apprentice license number ____________ Print apprentice name _________________________

Signature of apprentice _________________________

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Manicure

Artificial

Nail Fill In

Artificial

Nail

Nail

Pedicure

Nail

Professional

Air

Paraffin

Related

Total

Day Theory w/ hand /

Nail

Applications

Tip App.

Wrap-

Sculp-

w/foot

arts

Drill Usage

Brush

Treat-

Subjects /

Hours

forearm

Removal

 

w/Overlay

ping

turing

and leg

tech-

w/ drill

Nail

ment

Advanced

 

 

massage

& Nail

 

 

 

 

massage

nique

designs

Art

(Hand

Tech.

 

 

 

Repair

 

 

 

 

 

 

 

 

& feet

 

 

 

1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

29

30

31

Sworn to and subscribed before me

SEAL

Printed Name of Master _____________________________

This _______Day of ____________, 20 _____

 

 

 

 

Signature of Master ________________________________

Signature of Notary _________________________

 

 

My commission expires:

 

Master License # ____________________________

Printed name of salon/shop owner/mgr : __________________

Signature of Salon/Shop Owner/Mgr:__________________________

Revision Date July 2012

19

Georgia Board of Cosmetology Esthetician Apprentice Daily Log - Month/Year______________

Apprentice license number ____________ Print apprentice name _________________________ Signature of apprentice _________________________

 

Prof.

Prof.

Business

 

Sciences

 

Body

Facials

Make-up

Hair

Spa/Salon

Total

 

Day

Practices

Ethics

Practices

 

 

 

Treatment

 

 

Removal

Manag-

Hours

 

 

 

 

 

 

 

 

ment

 

 

 

 

 

 

 

 

 

 

 

 

 

 

1

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

2

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

3

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

4

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

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Sworn to and subscribed before me

 

SEAL

Printed Name of Master _____________________________

This _______Day of ____________, 20 _____

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Signature of Master ________________________________

Signature of Notary _________________________

 

 

 

 

 

 

 

 

My commission expires:

 

 

 

 

 

Master License # ____________________________

Printed name of salon/shop owner or manager :

 

 

Signature of Salon/Shop Owner/Mgr:

 

 

________________________________________

____________________________________________________________

Revision Date July 2012

20

APPLICANT: PLEASE CHECK THE FORM OF IDENTIFICATION BELOW THAT YOU POSSESS. RETURN THIS FORM ALONG WITH A COPY OF YOUR APPROPRIATE DOCUMENTATION.

________________________________________

Name

Secure and Verifiable Documents Under O.C.G.A. § 50-36-2

Issued August 1, 2011 by the Office of the Attorney General, Georgia

The Illegal Immigration Reform and Enforcement Act of 2011 (“IIREA”) provides that “[n]ot

later than August 1, 2011, the Attorney General shall provide and make public on the

Department of Law’s website a list of acceptable secure and verifiable documents. The list shall be reviewed and updated annually by the Attorney General.” O.C.G.A. § 50-36-2(f). The

Attorney General may modify this list on a more frequent basis, if necessary.

The following list of secure and verifiable documents, published under the authority of O.C.G.A.

§50-36-2, contains documents that are verifiable for identification purposes, and documents on this list may not necessarily be indicative of residency or immigration status.

_____ A United States passport or passport card [O.C.G.A. § 50-36-2(b)(3); 8 CFR § 274a.2]

_____A United States military identification card [O.C.G.A. § 50-36-2(b)(3); 8 CFR § 274a.2]

_____A driver’s license issued by one of the United States, the District of Columbia, the

Commonwealth of Puerto Rico, Guam, the Commonwealth of the Northern Marianas Islands, the United States Virgin Island, American Samoa, or the Swain Islands, provided that it contains a photograph of the bearer or lists sufficient identifying information regarding the bearer, such as name, date of birth, gender, height, eye color, and address to enable the identification of the bearer [O.C.G.A. § 50-36-2(b)(3); 8 CFR § 274a.2]

_____An identification card issued by one of the United States, the District of Columbia, the

Commonwealth of Puerto Rico, Guam, the Commonwealth of the Northern Marianas Islands, the United States Virgin Island, American Samoa, or the Swain Islands, provided that it contains a photograph of the bearer or lists sufficient identifying information regarding the bearer, such as name, date of birth, gender, height, eye color, and address to enable the identification of the bearer [O.C.G.A. § 50-36-2(b)(3); 8 CFR § 274a.2]

_____A tribal identification card of a federally recognized Native American tribe, provided that it

contains a photograph of the bearer or lists sufficient identifying information regarding the bearer, such as name, date of birth, gender, height, eye color, and address to enable the identification of the bearer. A listing of federally recognized Native American tribes may be found at: http://www.bia.gov/WhoWeAre/BIA/OIS/TribalGovernmentServices/TribalDirectory/ind

ex.htm [O.C.G.A. § 50-36-2(b)(3); 8 CFR § 274a.2]

_____A United States Permanent Resident Card or Alien Registration Receipt Card [O.C.G.A. § 50-36-

2(b)(3);

8 CFR § 274a.2]

_____An Employment Authorization Document that contains a photograph of the bearer [O.C.G.A. § 50-

36-2(b)(3); 8 CFR § 274a.2]

_____A passport issued by a foreign government [O.C.G.A. § 50-36-2(b)(3); 8 CFR § 274a.2]

Revision Date July 2012

21

_____A Merchant Mariner Document or Merchant Mariner Credential issued by the United States Coast

Guard [O.C.G.A. § 50-36-2(b)(3); 8 CFR § 274a.2]

_____A Free and Secure Trade (FAST) card [O.C.G.A. § 50-36-2(b)(3); 22 CFR § 41.2]

_____A NEXUS card [O.C.G.A. § 50-36-2(b)(3); 22 CFR § 41.2]

_____A Secure Electronic Network for Travelers Rapid Inspection (SENTRI) card [O.C.G.A. §50-36-

2(b)(3); 22 CFR § 41.2]

_____A driver’s license issued by a Canadian government authority [O.C.G.A. § 50-36-2(b)(3); 8 CFR §

274a.2]

_____A Certificate of Citizenship issued by the United States Department of Citizenship and Immigration

Services (USCIS) (Form N-560 or Form N-561) [O.C.G.A. § 50-36-2(b)(3); 6 CFR § 37.11]

_____A Certificate of Naturalization issued by the United States Department of Citizenship and

Immigration Services (USCIS) (Form N-550 or Form N-570) [O.C.G.A. § 50-36-2(b)(3); 6 CFR § 37.11]

_____In addition to the documents listed herein, if, in administering a public benefit or program, an

agency is required by federal law to accept a document or other form of identification for proof of or documentation of identity, that document or other form of identification will be deemed a secure and verifiable document solely for that particular program or administration of that particular public benefit. [O.C.G.A. § 50-36-2(c)]

Revision Date July 2012

22

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