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Enrollment Application

Please fill out all the questions. There is a $50 application fee, which you can pay when you come in for your free career planning session. Print the results page after you fill in the application, bring it with you, and save $10!


Please fill in all fields marked with a *
Name *
Address *
City *
State *
Zip *
Email *
Home Phone *
Cell Phone *
Employer *
Work Phone *
Date of Birth *
Social Security Number *
Drivers License Number *
Number of Dependents *
Ages
How did you hear about our academy?* *
I plan to enroll in* Cosmetology
Nail Spa Tech
Instructor
*
I would like this schedule * Full Time Days, M-F, 9-4:30
Part Time Days, M-F, 9-1
Part Time Evening, T-W-Th, 5-9, Battle Creek Only
*
I plan to take classes at * Battle Creek
Portage
*
I want to begin in * January
April
June
September
November
*
Last High School *
High School Grad Date *
High School GED High School
GED
*
Previous Colleges Attended *
Have you ever had a student loan Yes
No
*
Cosmetology School Transfer Only
Name of School		 *
Transfer School Address *
New and Transfer Students:
Do you want to apply for financial aid?		 Yes
No
*

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