MANE On Park Avenue - Student Application Form

MANE On Park Avenue Salon & School - Student Application Form
Instructions for filling in the Application Form

All Fields are required. If it is not applicable, please fill as "Not Applicable"

Step 1: Fill in the details
- Enter all relevant details carefully. Data Once Submitted can not be changed. So please take a look before the final Submission.
- Keep Ready a scanned color copy of the Student's Photo in jpg/jpeg format
- Take a Printout of the Application form before pressing the Submit Button. You can sign the hard copy of the application form and submit it along with copies of the documents.
- All copies of documents should be self-attested.
- The original documents should be brought to the school for verification and return
- The original transfer certificate from the current school (where applicable) will be retained by the School.

Profile Picture *

Browse Files

Cancel of
Student Information
Class Applying For
Cosmetology
Email *

Confirmation Email example@example.com
Student's Name *

First Name Middle Name Last Name
Date of Birth *

Day Month Year
Gender *
Current Address *

Street Address

Street Address Line 2

City State / Province

Zip Code

Student Information (Medical History)
Medicine Allergies, if any
Emergency Contact Information
Emergency Contact Name
Telephone number

Acceptance of Terms & Conditions

My Products

Monthly Option ( $ 200.00 for each month )

Bi-Weekly Option ( $ 100.00 for each two weeks )

$100 every other week for 25 weeks.

Weekly Option #1 ( $ 100.00 for each week )

$100 week @ 25 weeks

Weekly Option #2 ( $ 50.00 for each week )

$50 a week @ 50 weeks on Auto-Pay.

Credit Card For Payment
First Name	Last Name
Credit Card Number	Security Code
Expiration Date	Postal Code

Date

Day Month Year
Date
Please ensure the following before pressing the submit button
Your credit card will be charged today for the amount specified, and each option that you selected until satisfaction of note.
You are entering into a legally binding contract. There are no refunds on any monies paid.
Name

First Name Last Name
Please verify that you are human *
Signature

Clear
Student Photograph *
Should be Empty:

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