Dallas Medical Aesthetics Registration

Dallas
Medical Aesthetics Certification Program

Offered by
Dallas Center for Advanced Medical Aesthetics
School certified by the State of Texas

Medical Director

The Program

Registration for Medical Aesthetics
Reserve your space by registering now

Deposit including registration fees: $450.00 (NON-REFUNDABLE)
The balance is payable on 1st day of the class & is refundable less $100.00
Total Class tuition: $2900.00 for TX or CA

Full Name
Home Address
City
State	Zip
Home Phone & area code	Cell Phone
best time to call
Email
Social Security Number
Date of Birth
Educational Information
Highschool year graduated
College year graduated
Vocational Training Type	Year
Employment Background
Name of current employer
Area code & telephone
Job Title
Two references who could recommend you to attend the program:
(1) Full Name
Area code & telephone
(2) Full Name
Area code & telephone
Date of Class you would like to attend: Texas California
Method of payment:	MC Visa AMX Discover Money Order
Total Payment: $450.00 deposit
Yes. I would like to register for 3 extra days for permanent make-up training
Card Number Exp.Date
Name on Card
Do you need Hotel room: Yes NO
Date application submitted

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