Employment Verification Please fill out the form below to submit your employment verification online! Employment StatusEmployed?* Yes No Graduate InformationGraduate First Name*Graduate Last Name*Last 4 Digits Social Security Number*Program Completed*----------------CosmetologyNail TechnicianMassage Therapy 600 HourTherapeutic Massage and Allied Modalities 900 HourSkin Care 300 HoursAdvanced Esthetics 600 HoursHVAC 210 HoursHVAC 684 HoursHVAC/R 900 HoursRestricted BarberingCosmetology Make-Up SpecialistEmployment Date* MM slash DD slash YYYY Employer InformationCompany Name*Supervisor's Name*Mailing Address* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Phone*Email Preferred Method of Contact* Phone Email NOTICE: You may be called within the next 30 days to verify employment.Are you the graduate or the employer?* Graduate Employer Electronic Signature*Use your mouse or finger to sign in the box above.Date* MM slash DD slash YYYY
