Student Instructor Application
International Institute of Aesthetic Arts & Beauty
Personal Information:
Name
*
First Name
Last Name
Mobile Number
Mailing Address:
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Email
example@example.com
COURSE OF STUDY
Name of Course:
Please Select
Part Time
Full Time
Mode of Study:
Hybrid(On-campus & Online)
Distance Learning( 100% online)
Campus Learning (100% on campus)
Proposed Start Date:
02.15.22
04.05.22
05.17.22
Transfer
Registration and Enrollment
My Products
*
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Register & Enroll
This payment registers and enrolls you into the student instructor program. This payment is the first of 6. Honoring your $250 off offer. This is a non-refundable deposit that sets up your online profile and portal.
$
400.00
Pay In Full
This payment will cover the complete cost for your Instructor program. There is a non-refundable deposit with this payment that covers the cost of your online portal, T-shirts, and Instructor kit.
$
1,600.00
Credit Card
Signature
*
I certify that I understand this is a non-refundable deposit. My signature and initials indicate my acknowledgment of policies and procedures associated with this form.
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