CBH Our HAIR Interest Form

CBH Our HAIR Interest Form

Thank you for your interest in the CBH Our HAIR program! Please fill out the information below, and we will reach out to you shortly.

What is your interest in Our HAIR?

I am a salon/shop owner interested in the training

I am a barber/stylist interested in participating in the training

I represent an organization or group interested in collaborating

I am a community member interested in learning more about the program

Other

Your Name

Email Address

Phone Number

Name of Your Shop/Salon/Organization

Address of Your Shop/Salon/Organization

What zip codes/neighborhoods do you serve?

What age groups do you serve?

(Select all that apply)

12 and under

13-17

18-39

40-59

60 and older

Who do you serve?

(Select all that apply)

Men

Women

Children

How long have you been in business?

Do you own multiple locations?

Select or enter value

Why are you interested in Our HAIR?

Please provide any further information here:

Form Date Field

Send me a copy of my responses

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