Triad Barber School Application

TRIAD BARBER SCHOOL APPLICATION

Highest level of education completed High School Graduate GED Certificate Name of High School or Program Month/Year of Completion Desired start date to begin school:
Personal Information
Name
Date of Birth
Full Address
Phone Number
E mail
example@example.com
Social Security Number
Gender
Marital Status
Are you a veteran?

YesNo
Are you currently employed
If so, please list your place of employment and work shifts.
Please list any disabilities Triad Barber School should be aware of:
Admission Information
Highest Level of Education Completed
Name of High School or Program
Month and Year of Completion
Enrollment Information
Desired Triad Barber School Start Date
Desired Program Schedule
Have you attended barber school previously?
If so, how many hours are you transferring?
Hours must be approved, recognized, accepted by TRIAD Barber School and the NC Barber Board before acceptance into school and before signing the TRIAD Enrollment Agreement.

Yes, I understand
Criminal History

Please note: Former indiscretions will NOT necessarily disqualify you from admission.
Have you ever been found guilty or convicted of a felony?
If yes, please explain the nature of the crime(s), the county(ies) and state(s) in which the crime(s)
Have you ever been convicted of a sexual offense?

YesNoPending Sexual Charges
Emergency Contact Information
Name
Relationship
Relationship
Full Address
Phone Number
E mail
example@example.com
I certify the information that I have given is true and correct. I have also received or had access to all pre-enrollment information regarding Triad Barber School's outcome rates (prior to enrollment) for the students in the school, compensation a successful graduate may expect, the physical demands and safety requirements for the profession of barbering, state licensing requirements, orientation and a copy of the school catalog.
Date

MonthDayYear
Date
Date

MonthDayYear
Date
Signature of Parent or Guardian (if applicant is under 18)

Clear
TRIAD BARBER SCHOOL Application Addendum I
Student Applicant Acknowledgement of North Carolina Board's Statues Regarding Criminal Convictions

93B-8.1. Use of criminal history records. (a) (1) licensing board. (2) Board. - An occupational licensing board as defined in G.S. 93B-1. (3)Criminal history record. - A State or federal history of conviction of a crime, whether a misdemeanor or felony, that bears upon an applicant's or a licensee's fitness to be licensed or disciplined. (4) Licensee. - A person who has obtained a license to engage in or represent himself or herself to be a member of a particular profession or occupation. (b) Unless the law governing a particular occupational licensing board provides otherwise, a board shall not automatically deny licensure on the basis of an applicant's criminal history. If the board is authorized to deny a license to an applicant on the basis of conviction of any crime or for commission of a crime involving fraud or moral turpitude, and the applicant's verified criminal history record reveals one or more convictions of any crime, the board may deny the license if it finds that denial is warranted after consideration of the following factors: (1) (2) (3) (4)The circumstances surrounding the commission of the crime, if known. (5) The nexus between the criminal conduct and the prospective duties of the applicant

The following definitions apply in this section:

Applicant. - A person who makes application for licensure from an occupational

The level and seriousness of the crime. The date of the crime.

The age of the person at the time of the crime.

(6) The prison, jail, probation, parole, rehabilitation, and employment records of the applicant since the date the crime was committed. The subsequent commission of a crime by the applicant. (7) (8) Any affidavits or other written documents, including character references. (c)The board may deny licensure to an applicant who refuses to consent to a criminal history record check or use of fingerprints or other identifying information required by the State or National Repositories of Criminal Histories.
(d) This section does not apply to The North Carolina Criminal Justice Education and Training Standards Commission and the North Carolina Sheriffs' Education and Training Standards Commission. (2013-24, S. 1

§ 86A-18. Disqualifications for certificate. The Board may either refuse to issue or to renew, or may suspend or revoke any certificate of registration or barbershop permit or barber school permit for any one or combination of the following

Conviction of the applicant or certificate holder of a felony proved by certified copy of the record of the court conviction; (2) Gross malpractice or gross incompetence; (3) Continued practice by a person knowingly having an infectious or contagious disease after being warned in writing by the Board to cease practice; (4) Habitual drunkenness or habitual addiction to the use of morphine, cocaine or other habit forming drugs; (5)The commission of any of the offenses described in subdivisions (3), (5), and (6) of G.S.

(6) statute or rule or regulation of the Board, provided that the Board has previously given two written warnings to the individual committing the violation; (7)The violation of the rules and regulations pertaining to barber schools, provided that the Board has previously given two written warnings to the school. (1929, C. 119, S. 19; 1941, C. 375, S. 8; 1945, c. 830, S. 6; 1961, C. 477, S. 4; 1979, C. 695, S. 1; 1981, c.

The violation of any one or more of the sanitary rules and regulations established by

I acknowledge that I have been provided and read the board's statutes regarding criminal convictions.
Applicant/Student signature

Clear
Should be Empty:

Personal Information

Admission Information

Enrollment Information

Criminal History

Emergency Contact Information

TRIAD BARBER SCHOOL Application Addendum I