ILash & Aesthetics Enrollment Application

Enrollment Application
Date

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Please complete this application and submit with copies of your high school diploma or GED or HSED certificate, official high school transcripts, driver's license or state ID card, a letter of intent or short essay (use space provided), and a $50.00 non-refundable application fee. Missing or inaccurate data may result in application being returned as incomplete or may result in denial of your application.
Anticipated Start Date

MonthDayYear
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PERSONAL INFORMATION
Full Name
Social Security #
Present Full Address (include city, state, and zip)
Cell Phone
Email
Age
Birth Date
Martial Status
EDUCATION: Have you ever attended this or any other Cosmetology School. If yes, please attach official transcripts.

YESNO
File Upload

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High School or GED/HSED Issuing Body (include name, date and location)
College/ Trade #1 and Major (include name and location):
College/ Trade #2 and Major (include name and location):
EMPLOYERS: Please provide information for your current employer and/or most recent employment.
Employer Name and Phone:
Dates Employed
Position
Reason for leaving
Employer Name and Phone:
Dates Employed
Position
Reason for leaving
References: Please provide two personal references not related to you, whom you have known for at least one year.
Name of Reference #1

First NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number
Please enter a valid phone number.
Relationship to Reference #1
Name of Reference #2

First NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number
Please enter a valid phone number.
Relationship to Reference #2
HEALTH INFORMATION: The esthetic industry has demanding physical requirements, including standing and holding your arms at shoulder height for long periods of time, fine motor control and manual dexterity as well as hand and eye coordination By completing this application you certify that you are capable of meeting the physical requirements of the industry.
Do you have any physical limitations that preclude you from working in the esthetic industry? Please check all that apply.

Back problemsAnkle problemsAsthmaArm/Shoulder ProblemsWrist problemsLeg problemsOther
Any serious illness in the past year. If so, please explain:
If you checked any of the above, please explain:
Please write a short essay letting us know why you would like to be in the industry, why you feel you should be considered for acceptance and what your goals are upon completion of the program.
Use the space provided below.
CERTIFICATION AND AGREEMENT
Please read carefully: I hereby certify that the facts set forth in the above application are true and complete to the best of my knowledge. I understand that if accepted asa student, falsifed statements on this application shall be considered sufficient cause for dismissal You are hereby authorized to make any investigation of my personal history and financial credit record through any investigation or credit agencies of your choice. I understand that this application is only valid for six months after signing. and that any fees paid will be forfeited thereafter.
Signature

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Date

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Date

My Products

Application Feenonrefundable application fee

$50.00

Total

$0.00

Payment Methods

Credit Card

Apple Pay

Google Pay

Cash App Pay

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Enrollment Application

PERSONAL INFORMATION

EMPLOYERS: Please provide information for your current employer and/or most recent employment.

References: Please provide two personal references not related to you, whom you have known for at least one year.

CERTIFICATION AND AGREEMENT

Payment Methods