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Professional Trainer Application If you are interested in becoming a Certified Xtreme Lashes™ Trainer, please fill out the following application. Benefits include great compensation for teaching our unique procedure in your area, steep discounts on Xtreme Lashes™ products and an opportunity to be a part of one of the best Eyelash Extension Companies worldwide. Xtreme Lashes™ maintains the highest standards and we seek only the best trainers worldwide. If you believe you have what it takes to join our team please completely fill out the following application. * Indicates Required Fields Name:   * Company Name:    Your Website Name:      Is your facility large enough to conduct on-site workshops?   Yes    No   Address Line 1:   * Address Line 2:    City:   * State:  - Select A State - Akaroa Albert Town Albury Alexandra Amberley Arrowtown Ashburton Auckland Australian Capital Territory Balclutha Balfour Beachlands Beaumont Blackball Blenheim Bluff Brighton Brightwater Bulls Cambridge Carterton Cheviot Christchurch Clarksville Coromandel Cromwell Dannevirke Darfield Dargaville Drury Dunedin Duntroon Edgecumbe Eketahuna Eltham Fairlie Featherston Feilding Flaxmere Foxton Foxton Beach Frankton, Otago Frankton, Waikato Franz Josef Geraldine Gisborne Glenorchy Gore Granity Greymouth Greytown Haast Hakataramea Hamilton Hanmer Springs Hastings Havelock Havelock North Hawea Hawera Helensville Henley Hinuera Hokitika Howick Huntly Inangahua Junction Inglewood Invercargill Kaiapoi Kaikohe Kaikoura Kaitaia Kaitangata Karamea Katikati Kawakawa Kawerau Kawhia Kerikeri Kihikihi King Country Kinloch Kumara Kumeu Kurow Lawrence Leeston Leigh Levin Lincoln Little River Lower Hutt Lumsden Lyttelton Manaia Mangakino Manukau Maraetai Martinborough Marton Masterton Matamata Maungaturoto Mayfield Methven Middlemarch Millers Flat Milton Moeraki Moerewa Mokau Morrinsville Mosgiel Mossburn Motueka Mount Maunganui Mount Somers Murchison Murupara Napier Naseby Nelson New Brighton New Plymouth New South Wales Ngapara Ngaruawahia Ngongotaha North Shore City Northern Territory Oamaru Oban Ohakune Ohoka Ohope Beach Ohura Okato Omokoroa Opotiki Opunake Orewa Otaki Otakou Otorohanga Oxford Paekakariki Paeroa Pahiatua Paihia Palmerston Palmerston North Papakura Papatoetoe Paraparaumu Patea Pauanui Pauatahanui Petone Picton Piopio Pirongia Pleasant Point Plimmerton Porirua Port Chalmers Portobello Pukekohe Pukerua Bay Pukeuri Putaruru Queensland Queenstown Raetihi Raglan Ramarama Ranfurly Rangiora Raumati Reefton Renwick Richmond Riverhead Riverton Rolleston Ross Rotorua Roxburgh Ruatoria Runanga Russell Sanson Seddon Shannon Sheffield Silverdale Snells Beach South Australia Springfield Stratford Taihape Taipa-Mangonui Tairua Takaka Tapanui Taradale Tasmania Taumarunui Taupo Tauranga Te Anau Te Arai Te Aroha Te Awamutu Te Kuiti Te Puke Temuka Thames Timaru Tinwald Tirau Tokarahi Tokoroa Tolaga Bay Tuakau Turangi Twizel Upper Hutt Victoria Waharoa Waiheke Island Waihi Waihi Beach Waikanae Waikouaiti Waimate Wainuiomata Waiouru Waipawa Waipukurau Wairakei Wairoa Waitahuna Waitakere Waitara Waitoa Waitotara Waiuku Wakefield Wallacetown Walton Wanaka Wanganui Ward Wardville Warkworth Waverley Wellington Wellsford Western Australia Westport Whakamaru Whakatane Whangamata Whangamomona Whangarei Whiritoa Whitby Whitford Whitianga Willowby Winscombe Winton Woodend Woodville Wyndh  * Zip Code:   * Phone:    * Alternate Phone:        Fax Number:        Email:   * Best Time To Call:   Day   Evening Current Licenses or Qualifications:   * Services Offered:  Years of Experience:  Are you currently applying eyelash extensions?   Yes   No  *  If yes, how long?  If you are currently applying Eyelash Extensions, how did you learn the procedure? (Check all that apply)      Self Trained    Class/Workshop; Which school or company, date, location?     DVD by?      Other?      Are you currently using Xtreme Lashes™?   Yes   No If you are using other suppliers please list them here:  Technical Questions: Answer to the best of your ability 1. How many lashes per eye make up a complete set of eyelash extensions?   * 2. How much time does it take you to apply what you consider a complete set?  * 3. How many Eyelash Extension procedures have you completed?  * Other Comments / Questions:  Thank you for your interest in joining the Xtreme Lashes™ network of professionals trainers. An Xtreme Lashes™ representative will contact you as soon as possible.

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