Register I, the undersigned, hereby apply for membership with the Ethnic Beauty and Cosmetics Industry Association (EBCIA). I confirm that the information provided in this application form is true and correct. I agree to abide by the constitution, rules, policies, and code of conduct of EBCIA.Please enable JavaScript in your browser to complete this form.Name *FirstLastID / Passport Number *Date Of Birth *Gender *Nationality * Services Gender Business Physical Address *Postal Code *Cell Phone Number *Alternative Number *Email *Business / Salon Name *Type of Business *Hair SalonBarber ShopBeauty SpaCosmetics RetailNail TechnicianMakeup ArtistHair Products ManufacturerOtherBusiness Registration Number (if applicable)Business Address *Years in OperationNumber of EmployeesMembership Category *Individual MemberStudent MemberSalon / Business MemberAssociate MemberCorporate MemberHonorary MemberSkills & Services *BraidingWeavingNatural Hair CareBarberingHair TreatmentMakeupNailsBeauty TherapyCosmetics SalesTraining / EducationOtherPlease indicate the services or skills you providePurpose of joining EBCIASubmit
