School Application Form

School Application Form
Student Information
Name*

First NameLast Name
Do you have a high school diploma or GED*
Name of the High School you graduated or will graduate from. Month/Year of Graduation
Name of High School City and State MM/YYYY
Have you previously been enrolled in cosmetology, esthetics or barber school? If so please provide license number you were assigned. License #
Do you have a criminal history? This could effect your application for testing with TDLR.*

YesNo
Gender*
Date of Birth*

MonthDayYear
Date
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Email*
example@example.com
Phone Number*

Area CodePhone Number
Parent(s)/Guardian(s) Information (if applicant is under the age of 18)
Name*

First NameLast Name
Relationship*
Phone Number*

Area CodePhone Number
In one paragraph, tell us why you want to become an Aesthetician.
Type response here.
Date of Registration*

MonthDayYear
Date
How did you hear about us?
Should be Empty:

Student Information