Manicurist Application Form

Manicure Application Form
Personal Information
Student Name*

First NameLast Name
Date of Birth*

MonthDayYear
Date
Gender*

MaleFemale
Phone Number*
Please enter a valid phone number.
Email*
example@example.com
Social Security Number*
Ethnicity: *
Driver's License *
Present Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Previous/Current Education
School Last Attended*
Year Graduated/Last Year Attended*
School Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Parent/Guardian's Information

ONLY FILL OUT IF YOU ARE UNDER THE AGE OF 18
Parent/Guardian's Name - Primary*

First NameLast Name
Occupation*
Phone Number*
Please enter a valid phone number.
Date Signed

MonthDayYear
Date
Parent/Guardian Signature

Clear
Emergency Contact Information
In case of emergency, who will be notified? Please answer the fields below:
Emergency Contact Person*

First NameLast Name
Emergency Phone Number*
Please enter a valid phone number.
File Upload

2x2 Colored ID Picture, Can be a drivers license or Passport
Driver's License *

Cancelof
Health History
If the student has any known allergies, please list them down below: *
Does the student have any medical conditions or learning challenges that you would like to declare?*
How did you hear about us?*
Course of Study
Name of Course:*
Mode of Study*

Campus (100% on Campus)
Registration and Enrollment
Proposed Start Date*

09.22.25 (Day/Evening Classes)10.21.25 (Evening Classes)11.11.25(Day Classes)Other
Class Start: Which Date Would You Like to Enroll:*
Payment Plan Option: (Pick One)*

My Products*

New Enrollment Deposit (Funding Option) Product Image

New Enrollment Deposit (Funding Option) This option is for individuals who are planning on funding their tuition. Select this option. Please note you will still need to input your credit card information but you will not be charged.

$ Free

New Enrollment Deposit (Black Friday Special) 2 Product Image

New Enrollment Deposit (Black Friday Special) 2This option is for individuals who are planning on being on a payment plan. This serves as the deposit for the $5500 program. When this option is selected you are registering and enrolling in our manicurist program. The deposit is non-refundable.

$500.00

Transfer Student Deposit Students looking to transfer their hours. This is the option for you. This is a non-refundable deposit that sets up your online profile, orders your digital kit, and counts towards your overall balance.

$780.00 Quantity

Pay in FullAll in one Manicurist Program offering all the features to help you launch your career. This is a non-refundable deposit of $1033.

$5,500.00 Quantity

Total

$0.00

Credit Card

I certify that the information given on this application is true and accurate to the best of my knowledge and ability. I also acknowledge that the deposit in non-refundable once this application is submitted.
I certify that I understand the above statement.
Clear
Should be Empty:

Manicure Application Form

Personal Information

Previous/Current Education

Parent/Guardian's Information

Emergency Contact Information

File Upload

Health History

Course of Study

Registration and Enrollment

Credit Card