Application for Practical Examination
Government of the Virgin Islands of the United States Department of Licensing and Consumer Affairs Golden Rock Shopping Center Administrative Complex Property & Procurement Building 3000 Estate Golden Rock, Suite 9 “The Battery” 8201 Subbase, Suite 1 St. Croix, VI 00820-4311 St. John, VI 00830 St. Thomas, VI 00802-5826 Telephone: 340.713.3522 Telephone: 340.693.8036 Telephone: 340.714.3522 Facsimile: 340.773.6982 Facsimile: 340.776.6989 Facsimile: 340.776.8303 “Serving Businesses and Assisting, Educating, & Protecting Consumers” www.dlca.vi.gov VI BOARD OF BARBERS, BEAUTICIANS & MANICURISTS REQUEST TO TAKE EXAMINATION PRACTICAL REGISTRATION FORM 1. Full Name __________________ 2. SS# _____________________ 3. Mailing Address _______________________________________________ _______________________________________________ 4. Email Address_________________________________________________ 5. Business Telephone ____________ 6. Mobile Telephone ___________ 7. Please indicate which exam you will be taking by placing an (X) on the line. …
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Government of the Virgin Islands of the United States Department of Licensing and Consumer Affairs Golden Rock Shopping Center Administrative Complex Property & Procurement Building 3000 Estate Golden Rock, Suite 9 “The Battery” 8201 Subbase, Suite 1 St. Croix, VI 00820-4311 St. John, VI 00830 St. Thomas, VI 00802-5826 Telephone: 340.713.3522 Telephone: 340.693.8036 Telephone: 340.714.3522 Facsimile: 340.773.6982 Facsimile: 340.776.6989 Facsimile: 340.776.8303 “Serving Businesses and Assisting, Educating, & Protecting Consumers” www.dlca.vi.gov VI BOARD OF BARBERS, BEAUTICIANS & MANICURISTS REQUEST TO TAKE EXAMINATION PRACTICAL REGISTRATION FORM 1. Full Name __________________ 2. SS# _____________________ 3. Mailing Address _______________________________________________ _______________________________________________ 4. Email Address_________________________________________________ 5. Business Telephone ____________ 6. Mobile Telephone ___________ 7. Please indicate which exam you will be taking by placing an (X) on the line. Barber __________ Cosmetology __________ Esthetician __________ Manicurist __________ Hair Braiding __________ 8. Examination Administration: February 202_____ July 202_____ October 202_____ _________________________________________________ ____________________ Signature Date Examination Fee: $100.00 ______________________ _______________ Receipt # Date