Student Application
General
Course of study:
Cosmetology
Esthetics
Nails
Instructor
Name:
Required
First
Middle
Required
Last
Address:
City
State
Zip Code
Cell/Evening Phone:
Home Phone:
Email:
Required
Invalid format.
Health conditions:
Allergies:
What is your citizenship?
In case of emergency notify:
Name
Address
Phone
Personal Reference:
(not employer or relative)
Name
Address
Phone
Education
The Academy requires a high school diploma or G.E.D.
High School:
City
State
Year Graduated
Grade Average
Questions
How did you hear about The Academy?
Google
Internet
Newspaper
Print Ad
Salon Professional
Friend
Other
Why do you want to enter this career?
When would you like to start?
Cosmetology
January
February
March
April
May
June
July
August
September
October
November
December
09
10
11
12
Esthetics Month
January
February
March
April
May
June
July
August
September
October
November
December
09
10
11
12
Nail Tech Month
January
February
March
April
May
June
July
August
September
October
November
December
09
10
11
12
Have you ever been convicted of a felony?
Yes
Do you need any of the following while you attend school?
(check all that apply)
Financial Assistance/Aid
Transportation
Part-time work
Housing
Do you wish to be employed right after graduation?
Full-time
Part-time
Expected Salary
Would you like to recieve special offers and event invitations?
Yes
Send me information about future classes and school news?
Yes
I certify that all statements made in this application are complete and true.
Yes
Click Submit to send this
form to the Academy Admissions Department.
Thank you!
Submit
Required
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