South Carolina State Board of Registration of Professional ...

South Carolina Department of Labor, Licensing and Regulation

South Carolina Board of Cosmetology

P O BOX 11329, COLUMBIA SC 29211-1329 Phone: 803-896-4588 ? Fax: 803-896-4484

CONTINUING EDUCATION EXEMPTION FORM

Name:

(As currently shown on South Carolina License)

SC License Type:

Registered Cosmetologist (RC)

Instructor Registered Cosmetologist (IRC)

Esthetician (ES)

Instructor Esthetician (IES)

Nail Technician (NT)

Instructor Nail Technician (INT)

SC License Number: Original Date of Licensure by SC Cosmetology Board:

Original Date of Licensure by Out of State Cosmetology Board: (Please attach verification of licensure from original state of cosmetology licensure if not South Carolina)

Date of Birth:

Social Security Num:

(Attach proof of age, i.e., Birth Certificate, Driver's license.)

Physical Address:

Street

City

Mailing Address:

Street / PO Box

City

State State

Zip Code Zip Code

Telephone Number:

I am requesting Continuing Education Exemption based on: (See Section 40-13-250(A) below)

I have been licensed for fifteen (15) or more consecutive years and am sixty years of age or older

and have not been disciplined by the board

OR

I have been continuously licensed for at least thirty (30) years and am fifty (50) years of age or

older, and have not been disciplined by the board

Signature of Licensee: ___________________________________ Date: ____/____/____

Section 40-13-250 (A)The holder of an individual license issued by the board biennially, on such date as may be designated by the board, shall renew his license and pay the renewal fee and furnish proof to the board that he has completed continuing education approved by the board. A person who has held a license for at least fifteen consecutive years and is sixty years of age or older or who has held continuous licensure for at least thirty years, is fifty years of age, and who has not been disciplined by the board is exempt from taking continuing education courses. Upon approval by the board and submission of an attendance form prescribed by the board, a person may obtain continuing education credit by attendance at trade show cosmetology-related instructional programs.

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