Student Application
General
Course of study:
Cosmetology
Esthetics
Instructor
Name:
Required
First
Middle
Required
Last
Address:
City
State
Zip Code
Cell/Evening Phone:
Home Phone:
Email:
Required
Invalid format.
What is your citizenship?
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
Post Card
Salon
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
10
11
12
13
Esthetics Month
January
February
March
April
May
June
July
August
September
October
November
December
10
11
12
13
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
Invalid format.