ENROLLMENT APPLICATION


Basic information
Course of Study *
Name *
Name
Address *
Address
Phone # *
Phone #
Cell Phone # *
Cell Phone #
Can we text you?
Date of Birth *
Date of Birth
Education
The Academy requires high school graduation or a G.E.D.
Use this space for any additional training
Employment History
Address
Address
Phone #
Phone #
Start Date
Start Date
End Date
End Date
Address
Address
Phone #
Phone #
Start Date
Start Date
End Date
End Date
Use this space for any additional employers.
Questions
Please enter the class (Cosmetology, Esthetics, Nail Tech), and month/year.
Have you ever been convicted of a felony? *
Citizenship? *
Are you a veteran? *
Do you need assistance with any of the following while at school?
Please check all that apply.
Please explain.
By checking this box, you certify that all statements made in this application are complete and true. When you come in, you will be asked to sign the application and provide your social security number.