North Carolina Board of Cosmetic Art Examiners 1207 Front ...
North Carolina Board of Cosmetic Art Examiners nccosmo@ 919-736-6123
CONTINUING EDUCATION EXEMPTION FORM (20 Years' Experience Exemption)
This exemption form must be completed and returned to the Board for approval and exemption from the CE requirement.
Current name
Past/Maiden name(s)
Mailing Address
City ___________________
State _______________
Zip Code
Email Address
Telephone Number
Exemption Requirements: A licensed cosmetologist in active practice with at least 20 consecutive years of experience as a cosmetologist.
License Number Date of Birth
I, _________________________________, , certify that the information provided above on this form is true and correct, and as of the date below, I: (i) am a licensed cosmetologist; (ii) am in active practice as a cosmetologist; and (iii) have 20 or more consecutive years of experience as a cosmetologist (iv) am aware in the future I may be required to submit proof of my work experience.
This the ____ day of ________, 20___. Signature ________________________________
To upload this completed form directly to the Board follow these instructions:
Login at
Login Tips:
o use only the numeric portion of your license number e.g. 123456) o (The pin number for personal renewals is the last four digits of the licensee's social security
number.) Then click Individual Document Upload
For Board Use Only:
Approved Denied Date Initials
Revised April 8, 2020
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