BBI Enrollment Application

Enrollment Application
Full Legal Name

First NameLast Name
Preferred Name
Date Of Birth

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
State
Zip Code
Phone
*We will call you to schedule your tour/admissions meeting once we review your application.Format: (000) 000-0000.
Email Address
example@example.com
*Email will be our primary source of contact for the enrollment process.
- Please provide a valid email that you can easily acess frequently!
- Keep an eye out for confirmation emails to finalize your enrollment.
- Also, check your spam folder if our emails don't show up in your inbox.
Do you consent to us contacting you via email and by phone for enrollment and education purposes?
Are you a US Citizen?
Gender
Have you ever been convicted of a felony?
If yes, please summarize the charges:
Which program are you interested in attending?
Desired Start Date: When would you like to begin the program?
Application Fee: A non-refundable $100.00 application fee is required to process your enrollment application.

Payable to Bloom Beauty Institute
- You may pay in person via cash, check, money order.
- Pay online using a debit/credit card or a bank account HERE.
- Pay your Enrollment Fee Now with VENMO: @bloombeautyinstitute
Click our Venmo handle above to Venmo your Enrollement Fee. ⬆️

*Please include "Enrollment Fee" along with your First and Last Name as a note under "What's this for?" when making your Venmo payment.
I have already paid my non-refundable Enrollment Fee of $100 to Bloom Beauty Institute to begin my enrollment process.
I agree to pay a non-refundable Enrollment Fee of $100 to Bloom Beauty Institute via cash, check, money order, online or with Venmo to begin my enrollment process within 7 days of completing this Enrollment Application.
I agree to bring my Social Security card when I come in to meet with the Admissions team at Bloom Beauty Institute. (You may bring this when you come in for your signing appointment after you've been accepted into the program - we just need to make a copy for your student records)
EDUCATION
Which of the following have you earned?
High School Name
High School Location

Street Address Line 2

CityState

Zip Code
Graduation Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
GPA
Level of College Completed:
List any other College/Training attended after High School:
College/School Name
College/School Location

Street Address

Street Address Line 2

CityState

Zip Code
Graduation Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
GPA
EMPLOYMENT
Current Employment Status

Other
Company/Employer
Job Title
Phone
Format: (000) 000-0000.
Company/Employer Email
example@example.com
Company/Employer Address

Street Address

Street Address Line 2

CityState

Zip Code
Start Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Currently Employed Here
End Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Any Additional Employment History you would like to share?
EMPLOYMENT HISTORY
Company/Employer
Job Title
Phone
Format: (000) 000-0000.
Company/Employer Email
example@example.com
Address

Street Address

Street Address Line 2

CityState

Zip Code
Start Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Are you currently employed here?
End Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
PERSONAL REFERENCE

Reference #1
Name
Reference 1
Relationship
Address

Street Address

Street Address Line 2

CityState

Zip Code
Email
example@example.com
Phone
Format: (000) 000-0000.
PERSONAL REFERENCE #2
Name
Reference 2
Relationship
Address

Address

Street Address Line 2

CityState

Zip Code
Email
example@example.com
Phone
Format: (000) 000-0000.
EMERGENCY CONTACT
Name
Contact 1
Relationship
Address

Address

Street Address Line 2

CityState

Zip Code
Email
example@example.com
Phone
Format: (000) 000-0000.
EMERGENCY CONTACT #2
Name
Contact 2
Relationship
Address

Address

Street Address Line 2

CityState

Zip Code
Email
example@example.com
Phone
Format: (000) 000-0000.
MEDICAL INFORMATION
Please list any Allergies, Medical Conditions, etc.
Will any medical conditions affect your training? (If so, how)
HOW DID YOU HEAR ABOUT US?
How did you hear about us?

Other
Please Specify: who told you about us/what event did you learn about us at?
Important Enrollment Information
PLEASE NOTE: In addition to submitting this enrollment application, all applicants MUST Apply for Cosmetology Student License online through Missouri Division of Professional Registration to finalize enrollment.

*We will email you step-by-step instructions to help you complete this step after you submit this application*

For this process, students must:
- Upload proof of Education: High School Diploma, homeschooling certificate, GED or transcript
- Upload Proof of Citizenship – Birth Certificate, Passport, or Naturalization.
- Upload two digital headshot style photos of yourself (2”x2” passport photos)
Do you agree to complete the steps listed above to finalize your enrollment? *Enrollment will not be finalized until you submit the above info to the Missouri Division of Professional Registration and get your student license approved.
IMPORTANT PROGRAM DETAILS:
- A minimum of 1,500 hours of training in a licensed school are required for completion of a Cosmetology Class CA program in the state of Missouri to be eligible to sit for exams administered by the Missouri State Board of Cosmetology and Barber Examiners.
- Our Cosmetology program takes about 43-45 weeks (or 11 months) to complete.
- Class Schedule: Full-time, day program
  Mon - Thur . . . . . 8:30am - 4:30pm
  Friday . . . . . . . . . 8:30am - 3:00pm
  *Students get a 30 minute lunch break each day.
- Total tuition for our program is $19,000 including a deluxe cosmetology kit, manicuring kit, makeup kit, textbook and student iPad.
- Bloom Beauty Institute does not currently offer financial aid. (We are in the process of obtaining resources to offer financial assistance, private loans and federal aid.)
- Payment options include: In-house interest free payment plan, Pay-in-full , or you may obtain a personal loan through a lender of your choice.
- Bloom Beauty Institute is not eligible to offer a 1098-T form. As a result, tuition will not qualify for tax deductions or education credits.
I have read all important info and program details. I understand and agree to all of the above terms and conditions. I would like to proceed with enrollment.
Applicant Signature
Todays Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Should be Empty:

Enrollment Application

EDUCATION

EMPLOYMENT

EMPLOYMENT HISTORY

PERSONAL REFERENCE

PERSONAL REFERENCE #2

EMERGENCY CONTACT

EMERGENCY CONTACT #2

MEDICAL INFORMATION

HOW DID YOU HEAR ABOUT US?

Important Enrollment Information