Get Blank Salon Applications

Late fees will be imposed for late license renewals as is stated on the renewal application. NO REMINDER NOTICES ARE SENT. If you relocate you must take your independent contractor license and inspection sheet. License Fee 75. Board of Cosmetology 2515 Warren Ave. Suite 302Cheyenne WY 82002 Phone Number 307-777-3535 Fax Number 307-777-3681 APPLICATION FOR NEW INDEPENDENT CONTRACTOR LICENSE Print or Type In Black Ink Independent Contractor licenses expire on August 31st of each year and must be renewed on or before that date. If you relocate you must take your independent contractor license and inspection sheet. License Fee 75. 00 Date Type of personal license Your name Social Security -- Home Mailing address City State Zip Personal license Salon license Phone Cell Phone work E-mail address At the time of application what Salon are you working in City The undersigned says that he/she is acknowledging that the foregoing statements are made in good faith and are true in every respect. 00 Date Type of personal license Your name Social Security -- Home Mailing address City State Zip Personal license Salon license Phone Cell Phone work E-mail address At the time of application what Salon are you working in City The undersigned says that he/she is acknowledging that the foregoing statements are made in good faith and are true in every respect. Signature of Licensee If you are a salon owner you do not need an Independent Contractor s license For Board Use Only Date Processed Amount Processed Authorization Code This information will be shredded after processing To pay with Credit Card please complete the following form. A processing fee of 4. Late fees will be imposed for late license renewals as is stated on the renewal application* NO REMINDER NOTICES ARE SENT. If you relocate you must take your independent contractor license and inspection sheet. License Fee 75. 00 Date Type of personal license Your name Social Security -- Home Mailing address City State Zip Personal license Salon license Phone Cell Phone work E-mail address At the time of application what Salon are you working in City The undersigned says that he/she is acknowledging that the foregoing statements are made in good faith and are true in every respect. Signature of Licensee If you are a salon owner you do not need an Independent Contractor s license For Board Use Only Date Processed Amount Processed Authorization Code This information will be shredded after processing To pay with Credit Card please complete the following form* A processing fee of 4. 00 will be charged for credit card use for a total of 79. 00. WHEN COMPLETING CREDIT CARD INFORMATION USE BLACK INK AND PRINT CLEARLY Indicate card using VISA MASTERCARD DISCOVER Card Number Expiration Date Name on Card Billing Address Signature CVVC Code on back of card Phone 307 Revised 2/2011 w/f/applications. Signature of Licensee If you are a salon owner you do not need an Independent Contractor s license For Board Use Only Date Processed Amount Processed Authorization Code This information will be shredded after processing To pay with Credit Card please complete the following form* A processing fee of 4. 00 will be charged for credit card use for a total of 79. 00. WHEN COMPLETING CREDIT CARD INFORMATION USE BLACK INK AND PRINT CLEARLY Indicate card using VISA MASTERCARD DISCOVER Card Number Expiration Date Name on Card Billing Address Signature CVVC Code on back of card Phone 307 Revised 2/2011 w/f/applications.