top of page
Register Today
GENERAL INFORMATION
DESIRED PROGRAM/COURSE CERTIFICATION(S)
(select all that apply)
Facial & Chemical Peels
Laser/IPL Hair Removal
Laser/IPL Specialist
Microneedling
Microdermabrasion
Microblading
Medical Aesthetics Program
EMERGENCY CONTACT
Same address as applicant
If the emergency contact's address is different from the applicant's, please list it here:
Do you have or experience any health issues or medical concerns that could impact your training? (If yes, please explain):
EXTENDED APPLICANT INFORMATION
How did you hear about GLAMMED Canada?
When did you first become interested in these types of certifications?
Have you ever been enrolled in a medical aesthetics and/or aesthetics course?
Yes
If yes, please list the course name and school:
EDUCATION
High School:
City, Province/State:
Year Graduated:
Grade Point Average:
Other college(s), universities or extended education attended since high school:
School:
City, Province/State:
Major/Course:
Year Graduated:
School:
City, Province/State:
Major/Course:
Year Graduated:
EMPLOYMENT HISTORY
Company:
Phone Number:
Start Date:
Employer Name:
Position:
End Date:
(optional)
Company:
Phone Number:
Start Date:
Employer Name:
Position:
End Date:
I certify that all statements on this application are true and complete.
I understand that my application will not be considered complete without the applicable registration fees paid.
Your application was submitted successfully!
bottom of page