Deux Amis Spa and Wellness Academy

Secondary/Further/Higher Education

	Name of secondary School/College/University	Address	Dates Attended From(mm/yy)To(mm/yy)

Education Qualifications:

List all that apply
Employment:

Please give details of curent and previos employers,together with dates.

Employment information:

	Organization	Position held and summary of responsibilities	Date From(mm/yy)TO (mm/yy)

Statement In Support Of Application:

This section must be completed.You should state why you want to undertake this course,any relevant experience,skills and attributes,and your long terms goals.
Why do you want to become an esthetician?
Reference:

All aplicants must provide one reference.The referee should be a course tutor if you have been in education within the last two years or your current or most recent employer.
Name of Reference 1
Organization
Relationship to you
Reference contact info
Name of Reference 2
Organization
Relationship to you
Reference contact info
Please tell us how you found out about this course
Support Requirements:

Please complete this section if you have any learning support/mobillity requirements.
Do you have a disability, medical conditon or require learning support?

YesNo
If yes,please name and give brief details:
Declarations:
Do you have any unspent criminal convictions?*

YesNo
A criminal record will not necessarily be a bar to obtaining a place at Deux Amis Spa and wellness academy.
Declaration

I certify that, to the best of my belief, the information I have provided is complete and true.
Signature of Applicant

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Date

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Applicant Details: