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| DATE OF APPLICATION (dd/MM/yy): |
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| First Name: |
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| Middle Name: |
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| Last Name: |
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| Date of Birth |
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| Address: |
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| Location (where you are based): |
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| Contact Information (Home Tel): |
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| Contact Information (Mobile ph.): |
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| Email: |
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| How did you learn about our Training? |
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| Reason for training: |
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| Other Reasons: |
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| Are you on any medication? |
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If yes, please give us details
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| Do you have allergies? |
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If yes, please list them
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EDUCATION
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Name and Address |
Major / Subjects of Study |
Qualification |
| 1 |
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| 2 |
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| 3 |
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HAIR CARE 1
Base Preparation shampoo ,Conditioner, Shampoo &conditioner |
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Hair CARE 2
Base Preparation Shampoo, neutralizing shampoo& anti dandruff shampoo |
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BATH AND SHOWER 1
Liquid Bath Soap, Baby Liquid Soap & Shower Gel |
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BATH AND SHOWER 2
Shower Cream bath, Moisturizing bath soap ,foaming bath oils & anti-bacteria hand soap
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HOME AND JANITORIAL 1
Washing up liquid, Bathroom cleaning Soap, Hard Surface liquid soap& Dish wash detergent |
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HOME AND JANITORIAL 2
Powdered Laundry Detergent |
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SKIN CARE 1
Moisturizing Body Cream/Body Butter/Body lotion
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SKIN CARE 2
Facial Creams & Facial Scrubs
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SKIN CARE 3
Hand cream& hand and body cram
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SKIN CARE 4
Shea butter body cream
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| Other areas you will like to be trained |
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PREVIOUS EXPERIENCE
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| Please list the experience you have in the areas you have ticked |
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Please tick in the box if you have no experience in the areas ticked above
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2 X 6 =
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