AMHERST HEALTH DEPARTMENT All Tattoo/Piercing Technician ...
Source: www.amherstma.gov
Topic: Tattoo
Sort Desciption: Application for Tattoo/Piercing Technician License ... All Tattoo/Piercing Technician Applicants Must Provide the Following: ...
Content Inside: AMHERST HEALTH DEPARTMENT 70 BOLTWOOD WALK • AMHERST • MA • 01002 Office (413) 259-3077 Fax (413) 259-2404 Environmental Health Division (413) 259-3078 www.amherstma.gov _________________________________________ Application for Tattoo/Piercing Technician License Tattoo/Piercing Technician - ANNUAL FEE $325.00 Date: _______________________________________ DOB ___________________________ Name: ______________________________________ Tel. # ___________________________ Address: ______________________________________________________________________ (#, street, city/town, state, zip code, P. O. Box) Business Name: ______________________________ Tel. # ___________________________ Business Address: ______________________________________________________________ (#, street, city/town, state, zip code, P. O. Box) All Tattoo/Piercing Technician Applicants Must Provide the Following: [ ] Driver’s License, Passport or other photographic proof of identity and age . [ ]High School Diploma or its equivalent. [ ] Evidence of course completion in Preventing Disease Transmission (American Red Cross or its equivalent). [ ] Evidence of current certification (within last 2 years) in First Aid and CPR (American Red Cross or its equivalent ) [ ] Proof of completion of a course in Skin Diseases, Disorders and Conditions. (American Red Cross or its equivalent.) [ ] Proof of one year licensing as a tattooist or three (3) years apprenticeship training under a qualified tattooist from another state or municipality. [ ] Proof of one year licensing as a piercer or one (1) years apprenticeship training under a qualified piercer from another state or municipality. [ ] Piercing technician questionnaire must be completed. Questionnaire will be reviewed by the Public Health Nurse and she will determine if knowledge demonstrated is satisfactory. (To be completed in the office of Health Department) Have you ever had a license from another state or locality suspended or revoked? ...
