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*
LAST NAME*
PREFERRED NAME*
DATE OF BIRTH*
ADDRESS*
CITY, STATE, ZIP*
PHONE*
EMAIL*
EMERGENCY CONTACT*
EMERGENCY CONTACT PHONE NUMBER*
RELATIONSHIP*
CURRENT OCCUPATION
ARE YOU CURRENTLY LICENSED?*
No
Esthetician
Cosmetologist
Barber
Nail Technician
Other
LICENSE NUMBER (IF APPLICABLE)
STATE ISSUED
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?*
WHAT INSPIRED YOU TO ENROLL IN THIS TRAINING?*
WHAT DO YOU HOPE TO ACCOMPLISH AFTER BECOMING CERTIFIED?*
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
OTHER:
DO YOU HAVE ANY ALLERGIES TO:*
LATEX
CYANOACRYLATE ADHESIVES
MEDICAL TAPE
SENSITIVE SKIN PRODUCTS
NONE
OTHER
EXPLAIN OTHER:
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
IF YES, PLEASE EXPLAIN.
DO YOU HAVE ANY PHYSICAL LIMITATIONS AFFECTING YOUR HANDS, WRISTS, NECK, BACK, OR VISION THAT WE SHOULD BE AWARE OF?*
YES
NO
IF YES, EXPLAIN:
DO YOU REQUIRE ANY ACCOMMODATIONS TO HELP YOU PARTICIPATE IN CLASS?*
YES
NO
PLEASE EXPLAIN:
WHAT ARE YOUR THREE BIGGEST GOALS AFTER COMPLETING THIS COURSE? GOAL 1:*
GOAL 2:
GOAL 3:
WHAT CONCERNS YOU MOST ABOUT LEARNING EYELASH EXTENSIONS?
WHAT AREAS WOULD YOU LIKE ADDITIONAL HELP WITH?
HOW DID YOU HEAR ABOUT CRES EVERLASHING ACADEMY?*
FRIEND
FACEBOOK
INSTAGRAM
GOOGLE
WEBSITE
REFERRAL
OTHER
OTHER REFERRAL:
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):*