Join ISCC Form

Please fill out the form below on your computer and then print it out using the print button on your browser.

Make checks payable and mail this form with the appropriate membership fees to:

ISCC
2702 Covington Dr.
Garland, TX 75040

If you are paying with a credit card, you may fax this form to 972-530-3313 for faster processing.

ISCC Membership Application

First Name	Middle Initial Last Name
Street Address
Address (cont'd)
City	State/Province Postal Code
Country
Shop Name
Position/Title
Street Address
Address (cont'd)
City	State/Province Postal Code
Country

Home Phone	Fax
Business Phone
E-Mail
Web Page

Affiliations
Education
Expertise

Shop Affiliates		Salon Memberships can have up to 5 affiliates (employees) registered under their name. Affiliates are entitled to the same benefits as members while they are associated with their patron shop. It is not necessary to complete this list now as you can add or remove affiliates at any time.

I affirm that statements supplied by me on this form are true and correct. I understand that ISCC is a continuing education and certification program and agree to abide by all the rules, regulations, and standards for ethical conduct as outlined ISCC and its representatives.

Signature ________________________________ Date ____________

Type of Membership	Individual Salon	New Regular Pkg. Deluxe Pkg. Renewal New Regular Pkg. Deluxe Pkg. Renewal
Payment Method	check money order Discover VISA MasterCard American Express
	Card Number Expires Security Code (located on back of card)
	Signature ________________________________