Application for Enrollment

Name: 

Street Address:

City/State/Zip:

Mailing Address:

City/State/Zip: 

Home phone:  Cell:

May we text you from a computer? Select yes no

I have cell phone service with:  Select AT&T Nextel Sprint T-Mobile Verizon VoiceStream

Email:

Date of birth:   U.S. citizen?   Select yes no

Education: Education High school diploma GED certificate Current high school student College I don't have a diploma or GED

Program: Select a program Cosmetology Esthetics Manicure Student Instructor Transfer student    

Hours needed if a transfer student:

Schedule: Select a schedule Full-time (M-F 8a-4:30p) Part-time (M-F 8a-12p)   Start date: Select a start date 7/11/11 8/15/11 9/19/11 10/17/11 11/28/11 1/9/12 2/13/12 3/19/12 4/16/12 5/14/12 6/18/12 7/16/12

I need cutting shears for: Select Right hand Left hand