Kay Moriah ISB Registration Form

Please Do Not apply if you are applying to KMISB based on the Institution receiving Financial Aid (FAFSA). We are in the process of being accredited and cannot guarantee when we will begin accepting FAFSA. Payment plan options are still available at this time. Thank you for your Patience!

- Rolonda Bartnicki (Owner/Administrator)

Admissions Application

Fill out the form carefully for registration
Student Name*

First NameMiddle Initial Last Name
Birth Date*

MonthDayYear
Gender*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
E-mail*
example@example.com
Mobile Number*
Home Phone Number
Are you a U.S. Citizen?*
Do you have access to your Birth Certificate and Social Security Card?*

YesNo
Please enter your social security number*
Have you ever been convicted of a felony?*
*Please answer honestly as the school will verify before any determination of acceptance has been made*
Do you have any pre-existing medical conditions that could affect your ability to participate in class?*

YesNo
If "Yes", please describe the condition. Please understand that proper documentation and doctor release forms will be required for us to accept you into the program. *
*Note, this could potentially affect your acceptance, as your attendance to class, theory, and hands-on work is vital.*
Emergency contact/ Legal guardian information

Person must be over the age of 18 to be listed as an emergency contact or legal guardian.
Relationship*
Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*
Please enter a valid phone number.
Course Information
Application Status*

New ApplicantTransfer StudentFormer KMISB StudentReciprocityRefreshers course
If you're a transfer student, please list the school you transferred from and clock hours you received.*
*Note: official, stamped Transcript from previous beauty school, as well as a stamped letter documentation from your former school stating if you left school in good standing, with debts paid, will be required in order for any clock hours to potentially be applied to your program or to even be accepted into the program. However, KMISB reserves the right to accept or deny any transcripts from other beauty schools we feel do not meet our level of academic requirements.*
Program of Interest *
Keep in mind, applications must be submitted at least 2 weeks prior to the month you plan to start.
Term of study you plan to start *
Course hours*
*Dates and times are subject to change based on Holidays; Weather, & Other i.e., Covid). Evening Classes are pending enrollment of at least 6 students. If evening enrollment is low, Evening Classes may not run.*
Are you employed? (*Students that are 18-20 years old and working are only allowed to attend class as part-time evening.*)*
If yes, where? *
Will your employment schedule interfere with your school schedule?*

YesNo
Please list any employment history within the last 12 months including name of employer, time worked, and location.*
*This helps us understand your schedule a little better.*
If you reside outside the State of Indiana are your planning to be licensed in Indiana and get a reciprocity license in your state?*

YesNoN/A (Not Applicable)
Academics
Have you been suspended or dismissed from any Cosmetology school or college for academic, attendance or disciplinary reasons?*
If yes, please explain?*
List all educational institutions you are attending or have attended. Please list the name of the school/Institution, time you attended, and degree(s)/diploma you received if any. *
*Please list high school and college(s)/trade school(s) attended. Completion of High School or GED Equivalent is required to attend Kay Moriah International School of Beauty.*
Do you have a High School Transcript or Equivalent (GED) with Graduation date?*

YesNo
Please enter your high school graduation date or GED equivalent completion date*

MonthDayYear
Have you ever served in the U.S. Military?*

YesNo
Please list any Military service and current status. *
Personal Essay
Why do you feel KMISB is the school for you?*
What obstacles might prevent you from achieving excellent attendance and excellent academic performance?*
How did you hear about KMISB?*
What are some of your hobbies and interests?*
What are your long-term goals?*
What is your plan after graduating beauty school? Do you plan to own your own salon/spa/barbershop? Do you have employment arrangements or plan to find employment? Please explain why.*
Do you have any experience in the beauty industry?*
Why are you interested in your program of choice? (i.e. Cosmetology, Manicuring, Barber, Esthetics, Beauty Culture Instructor) Please take your time and explain why this career is your passion. *
Additional Comments
❖All prospective students must complete an Admissions Application and return it to the KMISOB campus.❖ All applications will be reviewed and approved by the school Administrator.❖ Incomplete applications will not be considered for review.❖ Applications received from an applicant with a felony conviction will be further reviewed by the schools’ owner/Administrator❖ Submitting an application does not guarantee admission. ❖ Prospective students will be notified by email and letter of approval or denial of admission. Please make sure we have your correct email address.❖ Kay Moriah International School Of Beauty Inc. reserves the right to approve or deny admission based on information gathered from the Admissions Application.
I certify that to the best of my knowledge, the information given in this application is true. I understand that any omission or misrepresentation of facts will be cause for refusal of admission, cancellation of application, or dismissal from KMISOB if later discovered. I further understand that, if I am approved and accepted into the program, it is MY RESPONSIBILITY to arrange for ALL ADMISSION CREDENTIALS (diploma, official transcripts, proof of US citizenship, down payment, etc.) to be received by the Admissions Office AT THE TIME OF MY ENROLLMENT.
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Please Do Not apply if you are applying to KMISB based on the Institution receiving Financial Aid (FAFSA). We are in the process of being accredited and cannot guarantee when we will begin accepting FAFSA. Payment plan options are still available at this time. Thank you for your Patience!

Admissions Application

Emergency contact/ Legal guardian information

Course Information

Academics

Personal Essay

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