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Academy Name *

Website URL *

Primary Contact Name

Instagram handle(s)

Role within the Academy

Primary Contact Email *

Primary Contact Phone Number *

Which bests describe your academy?

How long has your academy been operating?

Under 1 year

1-3 years

3-5 years

5+ years

Approximately how many students do you train per month?

1-10

11-25

26-50

50+

⁠Who do you primarily train?

Complete beginners

Beauty professionals

Aesthetics practicioners

A mix of the above

How do most of your students currently hear about you?

Why would adding a Harley Street Smiles teeth whitening partnership benefit your academy? *

Do your students currently ask about teeth whitening training?

Yes - frequently

Occasionally

Not yet, but we see demand growing

How would you describe your academy’s brand?

⁠Why do you feel your academy would be a good fit for the Harley Street Smiles Partner Network? *

⁠I confirm that I represent a registered beauty or aesthetics academy