Registration
A-1 Beauty & Barber College - Online
A-1 Beauty & Barber College
3129 Western Branch Blvd.
Chesapeake, VA  23321
Ph: 757 638 - 7600  Fax: 757 638 - 1537
    Registration  Form
* Required Fields all must be filled in
Your name:
(include Mr., Mrs., or Ms.)
Address:
City:
Zip Code:
State:
Birthdate:
(MM/DD/YYYY)
Sex:
(M/F)
U.S Citizen:
(Y/N)
Legal Alien:
(Y/N)
Email:
Phone Number:
SSN:
Driver's
License #
or State ID #:
Cosmetology:
(Y/N)
 Barbering:
(Y/N)
Course Of
Interest:
Braiding:
(Y/N)
Nail Technology:
(Y/N)
Waxing:
(Y/N)
Esthetics:
(Y/N)
Questions, comments, or feedback: