West Virginia State Board of Barbers and Cosmetologists
1201 Dunbar Avenue
Dunbar, WV 25064
Tel: 304.558.2924 Fax:304.558.3450
www.wvbbc.org
REQUEST FOR LICENSE CERTIFICATION
Please complete this form in its entirety. Incomplete forms will be rejected.
This application is a request to send your licensing and educational information to another state. This is NOT an application to renew your license in West Virginia. To renew your license online, go to www.wvbbc.com and click on "Individual License Renewal."

Requirement for Processing Include:
$35.00 processing fee
Completed Application
YOUR INFORMATION
SSN: License Number:
   
Name: License Number:
Address:
City: State:      Zip Code:
County: Phone:
 
STATE BOARD THAT WILL RECEIVE YOUR INFORMATION      
           
State Board Name:   Board Phone:
Board Address:
Board City: State:       Zip Code: