Advanced Cosmetology Registration Form

Registration Form
Name*

First NameLast Name
Date of birth *

MonthDayYear
Date
Email*
example@example.com
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*
Please enter a valid phone number.
What is your preferred method of communication? ( This is how our campus will contact you)*

PhoneText message
Are you able to make a payment of $500.00 each month? WE DO NOT OFFER FINANCIAL AID or FAFSA*

YesNo
Program of interest?*

Advanced Cosmetology Program 1,000 Hours
What excites you about Cosmetology?*
Why do you feel our beauty school is right for you?*
How soon are you looking to start?*
Do you have hours from another school? *
If yes, How long ago?*
How many hours do you have from another school*
Do you have hours from a previous school?*

YesNo
Which schedule best suits you ( In-person classes are Mon- Wed).*

DaytimeEvening
How many hours can you commit to weekly?*

15 or more20 or more25 or more30 or more
This program requires online and in-person hours weekly to satisfy the attendance requirements . *
Do you own the following?*
How would you describe your commitment level?*
Should be Empty: