School Application Form
STUDENT NAME
*
First Name
Last Name
PHONE NUMBER
*
PLEASE ENTER NUMBER INCLUDING AREA CODE
Email
*
example@example.com
AGE (must be at least 17 years old to attend school)
*
EDUCATION LEVEL COMPLETED
*
High School Diploma
GED
Are you using VA Education Benefits for School Tuition Payment?
*
Yes (Make sure you have your certificate of eligibility from the VA)
No
WHICH PROGRAM ARE YOU INTERESTED IN:
*
BARBER DAY 8:00am-4:00pm M-TH ($2,200 down & $900 per month for 12 months)
BARBER NIGHT 4:30pm-9:30pm M-TH ($2,200 down & $600 per month for 18 months)
BARBER CROSSOVER/Cosmetology License Required 8:00am-3:00pm T-W ($1,500 down & $500 per month for 6 months)
BARBER INSTRUCTOR/Barber License Required 8:00am-4:30pm M-W ($1,500 down & $500 per month for 9 months)
GENDER
*
Please Select
MALE
FEMALE
NON-BINARY
DATE OF BIRTH
*
-
Month
-
Day
Year
Date
HOME ADDRESS
*
Street Address Line 2
Street Address Line 2
CityState / Province
State / Province
Postal / Zip Code
How did you hear about us? Friend? Google? Instagram? Facebook? Other?
*
INTERESTED START DATE
*
IN CASE OF EMERGENCY, WHO WILL BE NOTIFIED?
*
Phone Number
*
Please enter a valid phone number.
Which handed are you?
*
Left Handed
Right Handed
HEALTH INFORMATION
IF THE STUDENT HAS ANY ALLERGIES, PLEASE LIST THEM DOWN BELOW:
*
IS THE STUDENT CURRENTLY TAKING ANY MEDICATIONS? IF YES, PLEASE LIST THEM BELOW:
*
ACKNOWLEDGEMENT
*
I certify that the information provided in this form is true and correct.
PARENT/GUARDIAN/SELF SIGNATURE
*
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