State of Louisiana LOUISIANA BOARD OF COSMETOLOGY 11622 Sunbelt Court, Baton Rouge, LA 70809 225.756.3404 (Phone) 225.756.3410 (Fax) Email: [email protected] Michael- John Gaspard, Chairman Allen D. Crochet Taquilla F. Hamilton Carolyn L. Robicheaux Jackie Burdette Metairie LA Westlake LA Harvey LA Baldwin LA Executive Director Frances K. Hand, Vice-Chairman Vivian L. Glaze Geneva L. Jones Aleshia J. Smith Stephen Young Denham Springs LA Pineville LA Benton LA Hahnville LA Assistant Director RECIPROCITY APPLICATION/FLORIDA I hereby make application to the Louisiana State Board of Cosmetology for certification of registration under the law of the State of Louisiana, and attach all requirements, together with a money order, or cashier’s check, made payable to the Louisiana State Board of Cosmetology. PLEASE PRINT NAME _______________________________________________________________________________________ ADDRESS____________________________________________________________________________________ CITY__________________________________________STATE _____________________ZIP CODE________ DAYTIME TELEPHONE NUMBER_____________________________________________________________ BIRTH DATE___________________________________ AGE______ SEX______ SS#____________________ STATE WHERE CURRENTLY LICENSED_______________________________________________________ STATE WHERE ORIGINALLY LICENSED_______________________________________________________ TYPE OF LICENSE APPLYING FOR____________________________________________________________ NAME OF BEAUTY SCHOOL ATTENDED______________________________________________________ EXPIRATION DATE______________________________ LICENSE #_________________________________ AN EQUAL OPPORTUNITY EMPLOYER State of Louisiana LOUISIANA BOARD OF COSMETOLOGY 11622 Sunbelt Court, Baton Rouge, LA 70809 225.756.3404 (Phone) 225.756.3410 (Fax) Email: [email protected] Michael- John Gaspard, Chairman Allen D. Crochet Taquilla F. Hamilton Carolyn L. Robicheaux Jackie Burdette Metairie LA Westlake LA Harvey LA Baldwin LA Executive Director Frances K. Hand, Vice-Chairman Vivian L. Glaze Geneva L. Jones Aleshia J. Smith Stephen Young Denham Springs LA Pineville LA Benton LA Hahnville LA Assistant Director REQUIREMENTS 1. CURRENT ORIGINAL LICENSE, (which will be returned after processing) 2. ONE CURRENT PICTURE (wallet size) 3. CERTIFICATION OF HOURS EARNED IN THE APPROPRIATE COURSE OF STUDY AT A SCHOOL THAT IS LICENSED IN THE STATE WHICH ISSUED THE LICENSE. PLEASE CONTACT THE STATE BOARD OFFICE IN THE STATE THAT YOU WERE ORIGINALLY LICENSED AND HAVE THEM MAIL THIS INFORMATION DIRECTLY TO OUR OFFICE. 4. LICENSE FEE OF $25.00 FOR A RESIDENT - $50 FOR A NONRESIDENT The only form of identification accepted by the Louisiana State Board of Cosmetology is a Louisiana Drivers License or State of Louisiana issued ID card along with a copy of the Social Security Card. 5. ALL APPLICANTS MUST TAKE A NATIONAL, A PRACTICAL AND A STATE WRITTEN EXAM, THE FEE FOR EACH EXAM IS $25.00. The state exam is based on Louisiana regulations. Copies of the regulations can be downloaded on the internet from the Office of State Register: www.state.la.us/osr/lac/46V31/46V31.pdf or a copy can be ordered from: State Register Division of Administration P.O. Box 94095 Baton Rouge LA 70804-9095 The document is the Louisiana Administrative Code, Title 46, Professional and Occupational Standards, Part XXXI. Cosmetologist. The cost for this handbook is $12.48 – the money order is to be made out to STATE REGISTER. 6. ALL FULL SPECIALIST TRANSFERS MUST TAKE BOTH THE MANICURIST AND ESTHETICIAN EXAMS. PLEASE SEE ATTACHMENT. The total fee for Louisiana residents is $100.00; for nonresidents, the fee is $125.00. DATE_________________________ SIGNATURE__________________________________ AN EQUAL OPPORTUNITY EMPLOYER .