Enrollment Application

HOW TO APPLY

1.) Complete this application

2.) Request official high school and post-high school transcripts be mailed to the Academy.

3.) Scheduled a tour, meet staff and students, and learn about our programs.

4.) Sign your enrollment agreement and pay your applicaton fee.
GENERAL INFORMATION
Legal Full Name*
First, Middle, Last
Preferred Name
Preferred Pronouns (optional)
example: he/him, she/her, they/them
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Cell Phone Number*

Area CodePhone Number
Permission to Text*

YesNoEmergency only
Cell Phone Carrier*
example: AT&T, Verizon, etc
Home Number (if applicable)

Area CodePhone Number
Email Address*
example@example.com
Social Security Number*
Birth Date*
mm/dd/yyyy
Are you a U.S. citizen?*

YesNo
Are you a veteran?*

YesNo
Dependency*

DependentIndependent
Ethnicity (check all that apply)*

Alaskan NativeAmerican IndianAsianAfrican AmericanCaucasianHispanicNative HawaiianNon-residentPacific Islander
Martial Status*

SingleMarriedDivorcedWidowedSeparated
Parent/Spouse Contact*
First & Last Name
Area CodePhone Number
Emergency Contact*
First & Last Name
Area CodePhone Number
EDUCATION

Official high school transcript with completion date or G.E.D. certification is required
High School*
City, State*
Graduation Date*
Month & Year
List all colleges/vo-techs attended since high school.
School
City, State
Graduation Date
Month & Year
Major/Course
School
City, State
Graduation Date
Month & Year
Major/Course
EMPLOYMENT HISTORY

Most recent
Employer*
Phone*

Area CodePhone Number
City, State*
Position*
Start Date*
mm/dd/yyyy
End Date*
mm/dd/yyy or "presently employed"
ENROLLMENT QUESTIONS
Preferred Program of Study*

CosmetologyEstheticsMassage TherapyNail TechnologyInstructor
How did you hear about The Academy?*
Why do you want to enter this career?*
Have you ever been convicted of a crime?*
If "yes", please explain
Do you have any health issues that could impact your training? Please explain.*
ex: allergies, medical conditions, etc.
PREFERRED START DATE:
Cosmetology
Esthetics
Nail Technology
Massage Therapy
I certify that all statements made in this application are complete and true.
Signature*

Clear
Date*
mm/dd/yyyy
Should be Empty: