Student Application Request
General
Course of study:
Cosmetology
Esthetics
Instructor
Name:
Required
First
Middle
Required
Last
Address:
City
State
Zip Code
Cell/Evening Phone:
Home Phone:
Email:
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Education
The Academy requires a high school diploma or G.E.D.
Year Graduated
Questions
How did you hear about The Academy?
Google
Internet
Newspaper
Print Ad
Post Card
Salon
Friend
Career Fair
Radio
High School Visit
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
11
12
13
14
Esthetics Month
February
November
11
12
13
14
Would you like to receive 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
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