SPCP TRAINER MEMBER

Application & Renewal

Please complete and submit this form for approval.

Date of Application *

Your Contact Information

First Name *

Last Name *

Phone *

Email *

Application Requirements

Are you an existing SPCP trainer member? *

YES, I am renewing my trainer membership

NO, I would like to apply

Are you an existing SPCP Professional or Lifetime member? *

Yes

No

Have you taken the SPCP Train the Trainer class? *

Yes

No

Date of most recent Train the Trainer Class you attended

Have you completed your Certified Permanent Cosmetic Professional (CPCP) certification and is it up-to-date? *

Yes

No

Trainer Information

Where are classes being held? Explain *

Are you in compliance with all local and state law requirements? *

Yes

No

Years in business applying permanent makeup *

Have you had formal instruction in the application of permanent makeup? Explain *

How many eyebrow procedures have you performed? *

How many eyeliner procedures have you performed? *

How many lip procedures have you preformed? *

How many breast procedures have you performed? *

How many skin re-pigmentation procedures have you performed? *

What program levels are you requesting to teach? *

Fundamentals ( Eg: brows/eyeliner/lips )

Intermediate ( Eg: advanced techniques )

Advanced (areola/scar)

What is your student/teacher ratio for hands-on training? *

How many beginning to end hands-on procedures will each student perform? *

Are your models required to complete informed consent forms? *

Yes

No

Do you teach the use of before & after photos? *

Yes

No

What forms do you teach the use of? *

Do you provide students with a course evaluation form? *

Yes

No

Are all your pigments/anesthetics approved for use in the Country you train *

Yes

No

Do you use new sterile needles for each client? *

Yes

No

Please upload a copy of your student curriculum that you teach. *

Have you added or changed your class/training programs since your last application? *

YES

NO

If yes, please upload a copy of your new student curriculum

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