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Bureau of Occupational Licenses

IDAHO STATE BOARD OF COSMETOLOGY

1109 Main St., Suite 220

Boise, Idaho 83702-5642

(208) 334-3233

e-mail

dfoss@ibol.state.id.us

APPLICATION FOR GLAMOUR PHOTOGRAPHY LICENSE

__________________________________________________________________________________________

Name of Photography Studio __________________________________________________________________________________

Location Address ____________________________________________________________________________________________

street

Apt. or room #

city

zip

Mailing Address _____________________________________________________________________________________________

street

Apt. or room #

city

state

zip

Name of Photography Studio Owner(s) __________________________________________________________________________

Photography Studio Phone #______________________

Home Phone #______________________

I hereby make application for a Glamour Photography license ($50.00 fee enclosed) which will expire on December 31 of the year in

which it is issued. Licenses will not be prorated for a partial year.

Anticipated opening date_____________________

(The appropriate shop license must be in your possession & conspicuously posted in the shop before offering services.)

Has a studio, cosmetics dealer, or cosmetology salon previously existed at this location?

[ ] YES

[ ] NO

If YES, give business name ____________________________________________________, license # _______________, and

owner's name ________________________________________________________________________________________________.

If YES & the license is current, that license (marked "out of business" & signed by the previous owner), or a written statement from

the previous owner surrendering ownership, must be submitted with this application,

Does this application represent a change in location of your studio?

[ ] YES

[ ] NO

If YES, give business name _____________________________________________________, license # _______________, and

former address _______________________________________________________________________________________________.

I certify that the above named studio meets all requirements as outlined by Idaho Laws & Rules, including the provision of facilities

and equipment in an area within the business premises to properly sanitize and store equipment and supplies necessary to perform any

cosmetological service provided.

I further certify that the required facilities and equipment include: access to hot and cold running water separate from the restroom

facilities; board approved hospital grade sanitation products which are evident and in use; single use samples, wipes, spatulas, or other

dispensing techniques designed to prevent contamination of multi-use cosmetic products and; restroom facilities.

I further certify that the information recorded hereon is correct to the best of my knowledge and belief.

__________________________________________________

Signature of owner or authorized agent

State of ______________, County of _________________________, ss.

Subscribed and sworn before me this ______ day of _______________________, 20 _____.

__________________________________________________

(seal)

Notary Public official signature

residing at _________________________________________

my commission expires ________________________________

(SEE DIAGRAM INSTRUCTIONS)

BOL-GP1-03/00

Application For Glamour Photography License Form - Bureau Of Occupational Licenses, State Of Idaho

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