Application

Instructions
Please fill out the form below, and click the SUBMIT button at the bottom of the screen to send us your application.

Your Name:	*
Salon/School representing:	*
Salon/School Address:	*
City:	*
State:	*
Zip:	*
Country:	*
Salon Phone:	*
Home Phone:
E-mail:	*
Choose one:	*
Cosmetologist License#:	*

Payments can be made in person or with money orders/checks to:
Salon Niquel
7021 Austin Street 2nd floor
Forest Hills, NY 11375
To make payment over the phone please call 718-268-5755

Method of payment:	*
Type of credit card :	*
Name that appears on Card:	*
Expiration Date:	*
Credit Card Number:	*
3 to 4 numbers that appear on back of Credit card:	*

For all online paymens a confirmation and receipt will be emailed to you

Any questions please call Salon Niquel at 718-268-5755
Tues-Sun
11am - 8pm

Comments:

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