AHBAI Salon Membership Application Form

Name: Ms. Mrs. Mr.(circle one) _________________________________________

Business Name:__________________________________________________________

Business 
Address:________________________________________________________________


City:_____________________________________ State:______ ZIP:____________

Business 
Telephone:_____________________________________ Date of Birth:__________

Home
Address:________________________________________________________________


City:_____________________________________ State:______ ZIP:____________


Telephone:______________________________________________________________


Please indicate where mail should be sent:

_____ Business        _____ Home



Please indicate your profession:

____ Barber
____ Barber Stylist
____ Cosmetologist
____ Esthetician
____ Make-up Artist
____ Nail Technician
____ Salon Manager
____ Salon Owner
____ School Owner
____ School Teacher
____ Student - Barber
____ Student - Cosmetology
____ Stylist
____ Other _______________________
          (Please specify)


License # ___________________________________________ State:_____

Are you actively engaged in your practice?

Yes ____  No ____  Full-Time ____  Part-Time ____


Applicant's signature:__________________________________________________

Date:___________________________________________________________________


Please return this application, a money order for $20 (made payable to AHBAI), and
a copy of your cosmetology license or cosmetology school enrollment papers to:


AHBAI Salon Advantage Club
401 North Michigan Avenue
Chicago, IL 60611-4267
312/644-6610

ALL APPLICATIONS ARE SUBJECT TO APPROVAL.