Specialty Lash Application

Eyelash Lash Specialty Application :

International Institute of Aesthetic Arts & Beauty
Full Name*

First NameMiddle NameLast Name
Birth Date*

MonthDayYear
Mobile Number*
Social Security Number*
Driver’s License Number*
Mailing Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
E-mail*
Phone Number*
How did you hear about us?
Course of Study Applied for:
Name of Course:*
Mode of study:*

Campus Learning (100% On-campus)Hybrid(Complete some class in-person & online)
Registration and Enrollment
Signature of Applicant

First NameLast Name
Please indicate which class date you would like to start on. Enrollment closes one week before the class starts.

Transfer Student05.20.25(Day Class)05.27.25(Evening)06.17.25(Evening)Other
Date

daymonthyear
Drivers License:

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Payment Plan Options

Pick the best option for you
Option 1 - 3 monthly payments $980Option 2 - 4 monthly payments $750Option 3 - 5 monthly payments $645Option 4 - 6 monthly payments $560Option 5 - customized payment schedule)Option 6 - FortifyOption 7 - WurthyOption 8 - Vocational and Rehabilition
Credit Card Information

Specialty Eyelash Program *

Deposit $780.00

This payment will enroll and register you for your eyelash extension specialty course. This payment is the first of 6. This is a non-refundable deposit, that orders your kit and sets up your online profile.

Pay In Full $3,640.00

This payment will cover the complete cost of your eyelash extension course. This payment includes a non-refundable deposit of $780

Total $0.00

Credit Card

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I Certify that the information given on this application is accurate and true to the best of my ability. I also acknowledge that the deposit is non-refundable once this application is submitted.
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Eyelash Lash Specialty Application :

Course of Study Applied for:

Registration and Enrollment

Payment Plan Options

Credit Card Information

Credit Card