Enrollment Application

Enrollment Application

268 South Mount Auburn Road Cape Girardeau, MO admissions@renaissancebeautyacademy.com
Applicant Name

First NameLast Name
Date of Birth

MonthDayYear
Date
Age
Place of Birth
Gender

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

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Are you left or right handed?
Social Security Number
Are you a US citizen?
Personal References
Personal Reference

First NameLast Name
Occupation
Phone Number
Please enter a valid phone number.
Personal Reference

First NameLast Name
Occupation
Phone Number
Please enter a valid phone number.
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.
Emergency Contact Person

First NameLast Name
Emergency Phone Number
Please enter a valid phone number.
Educational History
Applicant has:

High School DiplomaGEDStill enrolled in high school
High School
City and State
GPA
Date Graduated or Anticipated Graduation Date
Please list any other College/Training attended after high school, including the name of school, city and state, GPA and date graduated or anticipated graduation date, where applicable:
Program Information
Which program are you interested in?

Class CA - Hairdressing and ManicuringClass E - EstheticianOther
Why do you want to enroll in this program?
Do we have permission to text message you?

YesNo
How did you hear about Renaissance Beauty Academy?

InternetSocial MediaTVReferredOther
Preferred Start Date and Schedule Options

Please note, enrollment is limited. Once our program reaches the maximum capacity, you will be added to our waiting list. Your preferred schedule option may not be available at the same time as your preferred start date.
Preferred Start Date

January - MarchApril - JuneJuly - SeptemberOctober - December
Preferred Schedule Option

Class CA - Hairdressing and Manicuring: Schedule AClass CA - Hairdressing and Manicuring: Schedule BClass E - Esthetician: Schedule CClass E - Esthetician: Schedule DOther
File Upload

Please upload the following documentation:
- Final high school transcript with date of graduation (current transcript if still enrolled in high school)
- Transcripts from other post secondary institutions (if applicable)
- A proof of age such as a driver’s license or birth certificate
- A headshot style picture of yourself (see headshot guidelines below)
Headshot Guidelines per MO State Board of Cosmetology
- Photo must be 2 inches by 2 inches
- Color Photo
- Taken within the last 6 months to reflect your current appearance
- Taken in front of a plain white or off‐white background
- Taken in full‐face view directly facing the camera
- Use a clear image of your face. (Do not digitally retouch or change your photo using computer software, phone apps or filters, or artificial intelligence.)
- Do not wear a hat or head covering that obscures the hair or hairline, unless worn daily for a religious purpose.
- Your full face must be visible, and the head covering must not cast any shadows on your face.
- Headphones, wireless hands‐free devices, or similar items are not acceptable in your photo.
- This photo is of the individual only – no accessories, animals, etc.
Upload
Health History
Do you have any allergies or medical issues? If so, please list them below:
Terms
Interview - A school administrator will conduct an interview with the potential student as part of the admissions process.

All portions of this application are required to be completed. We cannot guarantee acceptance to every applicant.
Date Signed

MonthDayYear
Date
Signature

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Enrollment Application

Personal References

Educational History

Program Information

Preferred Start Date and Schedule Options

File Upload

Health History

Terms