NC State Beauticians & Cosmetologists' Assoc. - Open to all licensed cosmetologist, barbers and nail techs
Registration Form for Convention 2015
(please print)

Name_______________________________________________________


Address_____________________________________________________


City_________________________State_______Zip Code____________

Contact Number (_______)________-____________

Email_______________________________________

Cosmetology License#______________________

Members Chapter #________________

Choose 1 class for Sun._____________________________________________


Choose 1 class for Mon._____________________________________________


Pre-Registration

Members $100.00

Non Member $125.00

Certified Checks or Money Orders Only
Make to: NCSBACA, Inc.

Mail your registration fee & form to:

Dr. Jennifer Baylock - 762 Amber Dr.
Fayetteville, NC 28311
or
Ms. Loretta Miller -5605 Sunpath Cir.
Charlotte, NC 28269

Deadline for registration is
April 1, 2015


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