Cosmetology School Application 1Personal Information2Background Information3Questions & References Name* First Last Phone*Carrier Address* Street Address City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Email* Birth Date* MM slash DD slash YYYY High School* Year Graduated or Obtained GED College Year Graduated Most Recent Employer Employer PhoneCatalog FormIn what form would you like to receive the academy catalog? Electronic Copy (PDF) Physical Copy (Mailed) QuestionsPlease answer the following questions. Be as detailed and candid as possible.Which programs are you interested in attending?* Cosmetology Manicuring/Nail Technician Esthetics Instructor Training Are you interested in full time or part time?* Full Time - 40 hours Part Time - 30 hours How soon are you interested in starting classes?* Why are you choosing to go into Cosmetology/Esthetics?*Challenges and Overcoming Them*What do you see as your greatest challenge in school? Do you have any ideas on how you will be able to overcome this? Greatest Accomplishment*Please describe your greatest accomplishment. What did you learn from this event? How Did You Hear About Our School?Please briefly describe how you heard about us (TV, Radio, Social Media, etc.) ReferencesPlease list two people who know you personally and will provide character references. Include their names, addresses and phone numbers. Reference #1 Name First Last Reference #1 Address Street Address City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Reference #1 PhoneReference #2 Name First Last Reference #2 Address Street Address City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Reference #2 PhoneCommentsThis field is for validation purposes and should be left unchanged.