JavaScript is required

Please enable JavaScript in your browser to continue.

Student Intake & Training Profile

To ensure a successful training experience, all students are required to complete a pre-class intake form.

This form collects essential information including:

• Contact details

• Prior lash experience (if any)

• Allergies or sensitivities

• Health considerations relevant to training

• Learning goals and expectations

• Emergency contact information

This information allows Cres EverLashing Academy to provide a safe, structured, and supportive learning environment tailored to each student.

Students must complete this form prior to the training date.

FIRST NAME

Please fill out this field.

LAST NAME

Please fill out this field.

PREFERRED NAME

Please fill out this field.

DATE OF BIRTH

ADDRESS

Please fill out this field.

CITY, STATE, ZIP

Please fill out this field.

PHONE

Please enter a phone number.

EMAIL

Please enter a valid email address.

EMERGENCY CONTACT

Please fill out this field.

EMERGENCY CONTACT PHONE NUMBER

Please enter a phone number.

RELATIONSHIP

Please fill out this field.

CURRENT OCCUPATION

Please fill out this field.

ARE YOU CURRENTLY LICENSED?

No

Esthetician

Cosmetologist

Barber

Nail Technician

Other

LICENSE NUMBER (IF APPLICABLE)

Please fill out this field.

STATE ISSUED

Please fill out this field.

HAVE YOU EVER TAKEN A LASH CERTIFICATION COURSE?

YES

NO

HAVE YOU EVER APPLIED LASH EXTENSIONS?

NEVER

PRACTICED ON MANNEQUINS

PRACTICED ON FAMILY/FRIENDS

CURRENTLY ACCEPTING CLIENTS

APPROXIMATELY HOW MANY FULL SETS HAVE YOU COMPLETED?

Please enter a number.

Please fill out this field.

Please fill out this field.

DO YOU PLAN TO:

START A LASH BUSINESS

ADD LASHES TO MY CURRENT SERVICES

WORK IN A SALON

OPEN MY OWN STUDIO

I'M NOT SURE

OTHER

Please fill out this field.

DO YOU HAVE ANY ALLERGIES TO:

LATEX

CYANOACRYLATE ADHESIVES

MEDICAL TAPE

SENSITIVE SKIN PRODUCTS

NONE

OTHER

Please fill out this field.

DO YOU HAVE ANY HEALTH CONDITIONS THAT MAY AFFECT YOUR ABILITY TO PARTICIPATE IN A FULL DAY OF CLASSROOM AND HANDS-ON TRAINING?

YES

NO

Please fill out this field.

DO YOU HAVE ANY PHYSICAL LIMITATIONS AFFECTING YOUR HANDS, WRISTS, NECK, BACK, OR VISION THAT WE SHOULD BE AWARE OF?

YES

NO

Please fill out this field.

DO YOU REQUIRE ANY ACCOMMODATIONS TO HELP YOU PARTICIPATE IN CLASS?

YES

NO

Please fill out this field.

Please fill out this field.

Please fill out this field.

Please fill out this field.

Please fill out this field.

Please fill out this field.

HOW DID YOU HEAR ABOUT CRES EVERLASHING ACADEMY?

FRIEND

FACEBOOK

INSTAGRAM

GOOGLE

WEBSITE

REFERRAL

OTHER

OTHER REFERRAL:

Please fill out this field.

ARE YOU COMMITTED TO PRACTICING AFTER CLASS TO IMPROVE YOUR SKILLS?

YES

NO

DO YOU UNDERSTAND THAT MASTERING LASH ARTISTRY REQUIRES CONTINUED PRACTICE BEYOND THIS COURSE?

YES

NO

STUDENT FULL NAME (SIGNATURE ACKNOWLEDGMENT):

Please fill out this field.