New Jersey Ofce of the Attorney General
Division of Consumer Affairs
New Jersey State Board of Cosmetology and Hairstyling
124 Halsey Street, 6th Floor, P.O. Box 45003
Newark, New Jersey 07101
(973) 504-6400
Application for a Temporary Permit
Indicate the type of Temporary Permit you are applying for:
Cosmetology & Hairstyling Manicuring Skin Care Specialty
Barbering Beauty Culture Hair Braiding
Date:
Note
A temporary permit will be issued only to cosmetology/hairstyling students who have completed 1,200 hours of training, beauty
culture students who have completed 1,100 hours of training, barbering students who have completed 900 hours of training, skin
care students who have completed 600 hours of training and manicuring students who have completed 300 hours of training.
All of these applicants are seeking a temporary permit to work before the next opportunity to sit for the licensing exam. In
addition, a temporary permit will not be issued until the applicant has received authorization from the Board to sit for the next
licensing examination.
A nonrefundable application ling fee of $20.00, in the form of a check or money order made out to the State of New Jersey,
must be submitted with this application (applicants should understand that if the application ling fee is paid with a personal
check, and the check is returned by the bank due to insufcient funds, the next step in the application process will be
delayed until the fee is paid).
The Division is precluded by law from disclosing to the public the place of residence of licensees or applicants, without their
consent. However, you are required to provide an address that may be released to the public in our directories or in response to
other requests (by putting a check in the appropriate box). If you provide your place of residence as your public address
of record, we will assume that you have consented to have that address be disclosed. If you do not consent to the disclosure of
your place of residence, you should provide an address of record other than your place of residence that may be released
to the public. One of your addresses must include a street, city, state and ZIP code.
Information that you provide on this application may be subject to public disclosure as required by the Open Public Records
Act (OPRA).
Please print clearly. You must answer all of the questions on this application.
Personal Information Date of birth: ________________________
Month Day Year
Place of birth: _______________________
City State Country
Mr.
1. Name Mrs. ________________________________________________________________ ( _______________________)
Ms.
Last name First name Middle initial Maiden name
2. Address
Home: _____________________________________________________________________________________________
Street address City State ZIP code County
____________________________________ ___________________________________
Telephone number (include area code) E-mail address
Mailing: ____________________________________________________________________________________________
Street or P.O. Box City State ZIP code County
Photo #1
Photo #2
Attach two clear, full-face
passport-style photographs
(2˝x 2˝) of your head and
shoulders, taken within the
past six months.
Two photos are required with
each application.
Staple one photo here and one
in the square to the right.
