Liyah Marie School Application

Student application
Name

First NameLast Name
Gender
Date of Birth

MonthDayYear
Phone Number
Please enter a valid phone number.
Email
example@example.com
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Application for Admission Information
Application Type

CosmetologyEstheticsManicuristEyelash SpecialtyOther
Admission Application For

DaytimeEvenings (Part-Time)
High School Education
Name of Last High School Attended
Year Graduated

MonthDayYear
Date
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Why did you choose Liyah Marie?
Why did you choose the beauty industry?
If you are a transferree from another beauty/cosmetology school, please fill out the fields below:
Name of School Last Attended
Course Taken
Academic Year Last Attended
Please provide any academic achievements or awards you have received (if there is any)

Financial Information
How do you plan to pay for school?

JobLoanOtherGrant
Are you working? If yes, please provide details below. (We ask this question to ensure our schools schedule & attendance requirements align with your obligations to your job.)
Have you tried applying for scholarships with other organizations previously?

YesNo
Any information that might support your answer above
Our monthly tuition payments are $550. Would this be an issue to maintain each month?
How soon would you like to start?

I certify that the information I have provided above are true to the best of my knowledge without any malice or any intention to commit acts of misrepresentation.

I am aware that any false, misleading, or deceptive information provided may lead to withdrawal, expulsion, or any disciplinary action which may be dealt with by the school's authorities.
Name of Applicant

First NameLast Name
Applicant's Signature

Clear
Date Signed by Applicant

MonthDayYear
Date
Should be Empty: