TDLR Student Permit Application (20206/27)

Please know your name within this form must match your government identification or driver's license.

Fields with asterisk are required.

Last Name *

First Name *

Middle Name

Suffix (Jr. , Sr., III)

Social Security Number ( Do you have a SSN?) *

Please provide your SSN *

If you do not have a Social Security Number, you must complete and submit the Occupational License Application Claiming to Have No Social Security Number (PDF). Failing to complete and submit this form will delay your eligibility for examination and license issuance.

Birth Date (MM/DD/YYYY) *

Gender *

Phone Number *

Personal Email Address *

Provide your mailing address where you would like to receive mail from TDLR. A P.O. Box is allowed for this address. *

What type of classes are you taking? *

I certify that I will comply with all applicable laws and rules related to my licensed occupation or profession. I further certify that all information I have provided is true and correct. I understand that providing false information may result in denial of this application and/or revocation of the student permit. *

$25.00

Qty:

Product tags

cosmetology certificate (1)
,
class a barber (1)
,
cosmetology to barber certificate (1)
,
esthetician and skin care specialist certificate (1)
,
nail technician certificate (1)
,
skincare (1)