Form Bah - Barber And Hairdresser Application - Alaska Department Of Community And Economic Development
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7BAH
FOR OFFICE USE ONLY
Department of Community and Economic Development
Division of Occupational Licensing
Board of Barbers and Hairdressers
333 Willoughby, 9th Floor
P.O. Box 110806, Juneau, Alaska 99811-0806
(907) 465-2547
E-mail: license@dced.state.ak.us
BARBER AND HAIRDRESSER
APPLICATION
I am applying for a license in the State of Alaska by:
Waiver of Examination
Examination
I am applying for licensure in the following category:
Barber
Hairdresser
Temporary Permit or Temporary License Requested:
Yes
No
Total Due:
$ 50
Application Fee (nonrefundable)
$50 Temporary Permit/License Fee
$135
Initial License Fee
$55 Examination Fee
$20 Written
$35 Practical
Name:
Telephone: (Home)
(Work)
Mailing Address:
Address
City
State
ZIP Code
Social Security Number:
Sex
M
F Date of Birth:
(Required by AS 08.01.060)
Name of Hairdressing or Barbering School(s): (Use additional paper if necessary)
School
Address
Dates Attended
Total Hours
School
Address
Dates Attended
Total Hours
Licensing information: (List all states where you hold/have held a license.)
State
License #
Category
Date Issued
Expiration Date
State
License #
Category
Date Issued
Expiration Date
State
License #
Category
Date Issued
Expiration Date
Work Experience:
Name of Shop
Address
Dates of Employment
Name of Shop
Address
Dates of Employment
Name of Shop
Address
Dates of Employment
I hereby certify that the information contained in this application is true and correct to the best of my knowledge.
Signature of Applicant
Subscribed and sworn before me this
day of
,
,
SEAL
Notary Public
08-4193 (Rev. 2/01)
My Commission Expires:
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