Application Form

While this information in this form will be e-mailed to eHair College, please print out your completed application and send it along with the above information to:

eHair College, 359 Main Street, Steinbach, MB R5G 1Z4 

Name:

Address:

City/Town:   Province:

Postal Code:

Telephone:   Cellular:

E-Mail Address:  

Social Insurance Number:

Please reserve a spot in the following course:

Proposed Start Date:  

Funded by:

If Other, please specify:

Signature: _____________________________________________

       

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