Reserve Your Seat for a Class Student InformationFirst Name*Last Name*Address* Street Address City State / ProvinceAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Contact InformationEmail* Enter Email Confirm Email Mobile Number*By completing this form your mobile number will be used to send you updates from Danik MedSpa. Std. msg&data rates may apply. Reply HELP for help, STOP to cancel.Select a Course or Diploma ProgramSelect one*Select oneRegistration Fee for Diploma ProgramCourses & WorkshopsContinuing EducationSelect Diploma Program*Select oneSkincare Registration FeeElectrolysis & Laser Registration FeeSkincare & Electrolysis Registration FeeSelect Courses & Workshops*Select oneBody Wrapper CourseDeposit for Body Contouring WorkshopDeposit for Medical Aesthetician WorkshopDeposit for Microblading WorkshopDeposit for Eyelash Extension WorkshopDeposit for Makeup Artistry WorkshopSelect Continuing Education*Select one2-HR Body Wrapper CEU’s2-HR Hair Braider CEU’s2-HR Barber CEU’s2-Hr HIV/AIDS CEU’s4 Hr HIV/AIDS Salon Awareness CEU’s20-HR Electrology CEU’s10-HR Electrology CEU’sTotal $0.00 * Certain courses only accept deposits made online. Full final payment must be made on campus.Credit Card* American ExpressDiscoverMasterCardVisa Card Number Month010203040506070809101112 Year20212022202320242025202620272028202920302031203220332034203520362037203820392040 Expiration Date Security Code Cardholder Name I agree to FAMA's* I agree to FAMA's Cancellation & Refund Policy.Refunds will be made ONLY if the student submits written notification to the school more than 30 days before the start date of the class. Yes, you can send me texts regarding information from FAMA **By checking this box and clicking submit below, I expressly authorize FAMA to deliver to my phone number and/or email address, communications using an automatic telephone dialing system, an artificial and/or a pre-recorded voice by phone calls, text messages, voicemails, and emails advertising its services, products, promotions, appointment, account information. I can unsubscribe or provide notice to FAMA that I would like to opt-out at any time. I understand I’m not required to opt in to purchase goods or services.