• Personal Information

  • What phone number(s) may we contact you at?*
  • Is your permanent address different than your mailing address?*
  • Date of Birth*
     / /

  • Education Intent

    Note: Changing a start date after application submission will result in a $50 fee.
  • AIDM Program*
  • Start Date*
     / /
  • Have you attended an AVEDA Institute?*
  • What was the former start date?*
     - -

  • Health Insurance

  • Do you have health insurance?*

  • Residency Information

  • Are you a United States Citizen?*
  • Do you plan to return to that state upon completion of this program?*

  • Education History

  • Have you received a G.E.D. certificate?*
  • Have you attended a College or a Technical School?*

  • Extracurricular / Personal / Volunteer Accomplishments

  • Financial Intent

  • How will you be paying for school?*
  • Have you completed a FAFSA form?*

  • *Please note that the AVEDA Institute Des Moines does not participate in a Preferred Lender Arrangement and a student may use any lender of their choice who will approve a personal loan.

  • Criminal Background

  • Have you ever been convicted of a felony?*

  • A conviction will not necessarily disqualify you from acceptance.

  • Emergency Contact

  • Additional Information

  • Request for Confidential Information

  • The information requested below is voluntary. It may be used in reporting under federal and state laws and regulations. It will not be used as a basis for admission or in any discriminatory manner

  • Date of Birth
     - -
  • Residency

  • Student Certification

  • I CERTIFY THAT THE INFORMATION I HAVE PROVIDED FOR ADMISSION TO THE AVEDA INSTITUTE DES MOINES IS COMPLETE & ACCURATE TO THE BEST OF MY KNOWLEDGE. I UNDERSTAND THAT THE MISREPRESENTATION OF INFORMATION IS SUFFICIENT GROUNDS FOR CANCELING ADMISSION TO THE AVEDA INSTITUTE DES MOINES.

  • Date
     / /
  • Reload
  • Should be Empty: