MAIN STREET SALON SERVICES LOGO
MAIN STREET SALON SERVICES INC - REGISTRATION

MAIN STREET SALON SERVICES REGISTRATION FORM


Use the form below to register to become an
PRESTIGE SALON and receive
your MAIN STREET SALON SERVICES INC
User ID and Password

Please be advised your User Id and Password
will be e-mailed to you opon receipt of
a copy of your cosmetology license.

Please provide the following contact information:

*Required fields are in red

Name*
Title
Street Address*
Address (cont.)
City*
State/Province*
Zip/Postal Code*
Country*
Home Phone
E-mail

Please provide the following salon contact information:

Salon Name*
Street Address*
Address (cont.)
City*
State/Province*
Zip/Postal Code*
Country
Work Phone*
FAX
E-mail*
URL

Please provide the following license information.

License number?
Enter the date of expiration : -- mm/dd/yy
State License Issued by :


Please be advised you will be sent your User ID and Password
once we receive a current copy of your license.

You may submit your license to Nairobi®
Professional by mail, fax or e-mail to:

mail a copy of license to:
Main Street Salon Services, Inc.
P.O. Box 1779
NEW ROCHELLE, NY 10802

fax a copy of license to:
1.914.667.2793

e-mail a copy of license to:
info@mssny.com