Form B-37 - Application For Barber Licensure
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2STATE OF IDAHO
BUREAU OF OCCUPATIONAL LICENSES
1109 Main Street, Suite 220
Boise, Idaho 83702-5642
APPLICATION FOR BARBER LICENSURE
(see instructions)
Please complete this form by providing the requested information (please print) and the required fees. Your signature
must be notarized and any supporting documentation must be attached. Submit the completed form to the address noted.
NOTE: ANY PRACTICE PRIOR TO OBTAINING A VALID WORK PERMIT OR LICENSE IS UNLAWFUL
AND MAY RESULT IN CRIMINAL PROSECUTION AND DENIAL OF LICENSURE.
I hereby submit my qualifications and make application for a license to practice barbering in the State of Idaho under the
provisions of Title 54, Chapter 5, Idaho Code as amended.
1. Full Name (Mr., Mrs., or Ms.) _____________________________________________________________________
2. Mailing address_________________________________________________________________________________
Street
City
State
Zip
3. Place of Birth
Date of Birth _______/_______/_______
month
day
year
(Proof of age must be attached. A copy of your birth certificate, passport, military ID, or valid driver’s license is acceptable.)
4. Social Security No. ______-____-______ Home phone number (____)____________ E-mail _________________
th
5. Do you have at least a tenth (10
) grade education or the equivalent?
[ ]Yes [ ] No
(If you did not receive your training in Idaho, proof of education must be attached. A copy of your high school diploma, transcript,
GED, or CPAt is acceptable.)
6. Have you graduated from a course of training of at least 1700 hours? (§ 54-506, Idaho Code)
[ ]Yes [ ] No
(If Yes, documentation of said training must accompany this application.)
7. Have you ever been convicted of any State or Federal felony?
[ ]Yes [ ] No
(If Yes, a detailed statement, including a summary of the charges, the final order, any probation or parole documentation, and any
other relevant information must be attached.)
8. Are you licensed in any state to practice barbering wholly or in part?
[ ]Yes [ ] No
(If Yes, certification of licensure must be received directly from the licensing authority before your application will be processed.
Attach a copy of your license, and complete all sections of the attached addendum. If No, complete addendum sections A & C.)
9. Do you wish to receive a work permit?
[ ]Yes [ ] No
(An additional $15.00 permit fee must be attached. Work permits allow practice only under supervision, are issued only once and
expire upon receipt of your exam results.)
AFFIDAVIT
I hereby certify that I am the person named above and that I have no infectious or contagious disease which may pose a threat to the
general public and that I am of good moral character and temperate habits. I swear or affirm that the information provided on and
attached to this application is true and accurate to the best of my knowledge and belief. I further certify that I have successfully
completed the required training program and have been duly graduated and that I have received and will comply with the Idaho Laws
and Rules governing the practice of barbering. I hereby authorize and direct any person, agency, firm, or other entity to release to the
Bureau of Occupational Licenses or it’s identified agent any and all information, communications recommendations, reports, records,
statements, or disclosures, whether public, privileged or confidential, that may relate to my professional qualifications or credentials or
that may have bearing on my eligibility for licensure.
______________________________________________________________
Signature of applicant
State of ______________, County of _________________, ss.
Subscribed and sworn before me this ______ day of _______________________, 20 _____.
(seal)
_____________________________________________________________
Notary Public official signature
residing at____________________________________________________
my commission expires
__________________________________________
B-37 revised 11/99
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