Name *

First Name

Last Name

Phone *

(###)

###

####

Are you comfortable in front of the camera? *

Yes

No

Are you able to patiently lay for 3 hrs on your back? *

Yes

No

Have you had eyelash extensions before? *

Yes

No

Model services require a full healthy, lash line. Are your natural lashes in healthy condition? *

Yes

No

Are you flexible to model mid week or Sunday mornings? *

MM

DD

YYYY