Scholarship Application

Please fill in all fields marked with a *
	Name	*
	Address	*
	City	*
	State	*
	Zip	*
	Email	*
	Home Phone	*
	Cell Phone	*
	Employer	*
	Work Phone	*
	Date of Birth	*
	I plan to enroll in	Cosmetology Nail Spa Tech
	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 enroll in	Battle Creek Portage *
	I want to begin in	June September *
	Last High School	*
	High School Grad Date	*
	High School GED	High School GED *
	Please write 2-3 Paragraphs about your goals: