JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
Application for Courses offered by LASE Acadamea
Fees for the course Diploma in Scientific Electrolysis (DSE) is USD 997. WhatsApp:
+91 97 44 95 3708, or write to us by email to
hello@laseacadamea.org
Practicals are offered online only to those who have access to Electro-Epilators.
* Indicates required question
Email
*
Your email
Date of proposed joining
*
Flexible dates are available
MM
/
DD
/
YYYY
Name of Applicant
*
Your answer
Applicant's email id
*
Your answer
Applicant's Gender
*
Female
Male
Transgender
Applicant's Date of Birth
*
MM
/
DD
/
YYYY
Applicant's Nationality
*
Your answer
Applicant's Father's Name
*
Your answer
Applicant's Passport Number / If no passport answer 'Nil'
*
Your answer
Applicant's Passport Expiry Date
MM
/
DD
/
YYYY
Applicant's National Id Card Number
*
Your answer
Applicant's Educational Qualification (Tick against all applicable answers, do not restrict to one only)
*
10th Grade
Higher Secondary School (12th Grade)
Graduation (BA, BSc, BCom, BTec etc.,)
Post Graduation (MA, MSc, MBA etc.,
General Nursing Qualfication
BSc Nursing
Beautician Qualification
Ayurveda Qualification
MBBS (Medicine)
Dermatology
Cosmetology
Other:
Required
Applicant's Work Experience (Describe in detail one by one numbering 1, 2, 3......) / If no Work Experience answer 'Nil"
*
Your answer
Applicant's Telephone Numbers (Give all numbers where the Applicant could be accessed)
*
Your answer
Applicant's WhatsApp Number (If no WhatsApp numberr answer 'Nil')
*
Your answer
Applicant's Postal Address where letters could be delivered
*
Your answer
PIN/Post Code Number
*
Your answer
How did the Applicant come to know about LASE Acadamea
*
Website of LiLi (
www.lilielectrolysis.com
)
Internet search
facebook notifications
Insatgram
LinkedIn
Other Social Media
Newspaper Ad
Alumni (old students) of LASE Academy
Blogs
Referral
Facebook/ Instagram Ad
Required
Do you intend to work as electrology specialist
*
Yes
No
Would you like to become Franchisee of LiLi Aesthetic Clinic
*
Yes
No
If 'Yes' Which City & Country
Your answer
Would you like to set up your own Permanent Hair Removal Clinic
*
Yes
No
If 'Yes' which City & Country
Your answer
Would you like to purchase Electro Epilators from us?
*
No
Yes
Are you a sponsored Applicant
*
Yes
No
If 'Yes' mention Name and Contact details of the sponsoring Company
Your answer
From which country you have an offer for job? If you do not have an offer, mention 'Nil"
*
Your answer
If you have a job offer in hand, what is the name of the company?
Your answer
A copy of your responses will be emailed to the address you provided.
Submit
Page 1 of 1
Clear form
Never submit passwords through Google Forms.
reCAPTCHA
Privacy
Terms
This content is neither created nor endorsed by Google.
Report Abuse
-
Terms of Service
-
Privacy Policy
Forms