Student Application
   

General

  
   
Course of study: Cosmetology Nails Massage Instructor
   
Name:
Required
First
Middle		 Required
Last
   
Address:
City
State
Zip Code
   
Cell/Evening Phone:
Home Phone:
Email: RequiredInvalid 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?
Why do you want to enter this career?
   
When would you like to start?  
Cosmetology
Esthetics Month
Nail Tech Month
   
Have you ever been convicted of a felony? Yes No
   
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!		 RequiredInvalid format.