Employer Information

Employer Name:*

Employer Email:*

Employer Salon Name:*

Employer Street Address:*

Employer City:*

Employer Province / State:*

Employer Country:*

Employer Postal Code / Zip Code:*

Employer Phone #:*

Employer Web / Facebook Address: (if applicable)

Are you a JKL Graduate?*

Yes   No

Is this training for first or subsequent employee?*

First  Subsequent

If subsequent, provide the name of first employee:*

Current Employee's relationship to you:*

Please select: Friend Relative Self Salon Employee Mobile Employee