Cosmetologists and Barbers of Iowa - CBI Home



CBI Membership Application/Renewal Form

Please check:

( New CBI Member ( CBI Student Member ( CBI Renewal ( CBI Associate

First Name: __________________________Middle Initial: ______Last Name: ________________________

Address: _________________________________________________State: ____________ Zip ___________

Primary Phone: ______________________________Alternate Phone: _______________________________

Email Address: ____________________________________________________________________________

Primary Area of Practice: Please Circle all that apply

Cosmetology, Esthetics, Nail Technology, Cosmetology Instructor, Barber, Barber Instructor, Associate

Electrology, Other: ___________________

License Number: ____________________________State from which License is issued: _________________

Classification: ____________________________________________________________________________

(Salon Owner, Salon Employee, Independent Contractor, School Owner, Educator/Instructor)

NOTE**New Members will be assigned a CBI Member Id Number

Current CBI Members fill out ID # and CBI Affiliate which you belong to:

CBI Member ID # __________________ CBI Affiliate # __________________

(Members after 2006 include “CBI” as your ID) Example; correct – “CBI 2468”……incorrect – “2468”

Renewing your CBI Membership

Payment forms accepted: (see membership and payment cost and information on page 2)

Check or Money Order Payment with the completed CBI Membership Application/Renewal Form to

CBI Treasurer-Jenni White

Check or Money Order Payable to: “CBI” or “Cosmetologists and Barbers of Iowa” and mail to:

Jenni White

2923 Valley High Dr

Cedar Falls, Iowa 50613 Email: jenfred12@  Phone: 319-830-0254.

Credit Card Payment - Print Registration Form with info needed for Credit Card payment found on page 2 (next page)

✓ Credit Card Payment will have an automatic $5.00 fee added for use

✓ Dues paid after expiration date will have an additional cost of $ 10.00/Month

(grace period 7-10 days following expiration date)

✓ Returned checks/insufficient funds will need to pay $15.00 service charge

CBI Membership Payment Information:

STATE MEMBERSHIP    $95 

Professionals holding a cosmetology, esthetics, nail tech, barber, salon owner or school owner, electrology and instructors license. 

*Renew annually

Military State Membership    $75 

Includes any Military person (Active/Non Active). For professionals that hold that holds a cosmetology/barber, esthetics, nail tech, salon owner or school owner, electrology and instructors license.  

*Renew annually    

ASSOCIATE MEMBERSHIP   $95   

Includes all that are not Licensed

Example: School owner that does not hold a license. 

*Renew annually

STUDENT MEMBERSHIP   $50   

Student currently enrolled in cosmetology/barber, esthetics or nail technology course at a licensed school. Student Membership is for one year.

*Renewals after a one year period will renew at the **State Membership rate. 

(******************************************************************************************************************************************Credit Card Payment Information

Please submit the following information for the CBI Treasurer to process any Credit Card Transactions using Credit Card Square. The completed attached form may be mailed, emailed or scanned to:

Jenni White

2923 Valley High Dr

Cedar Falls, Iowa 50613   Email: jenfred12@  Phone: 319-830-0254.

Please include all information to be processed with the form.

Name (as printed on card) ________________________________________________________

Credit card # (_________-________-________-________) Expiration (__ __/__ __) Security code (__ __ __)

Address (including zip code) ________________________________________________________

Contact Information for processing

Home Phone (_____) ____________________ Cell Phone (_____) ____________________

Work Phone (_____) ____________________ Email _____________________________________________

There will be a $5.00 fee added for processing when using credit cards for EACH credit transaction. To avoid this fee please pay with check or money order. If CBI Renewals are past due a $10/month will be added, if paid within the grace period, 10th of the month following expiration date, no fee will be added.

-----------------------

[pic]



................
................

In order to avoid copyright disputes, this page is only a partial summary.

Google Online Preview   Download