Application for Enrollment

Date

Last Name, First Name

Address

City, State, Zip

Phone

cell phone

email address

Marital Status

Spouse Name (if applicable)

Highest Level of Education

I have a
High School Diploma

G.E.D.

Associates Degree

Bachelor's Degree

Master's Degree


Name/City/State of college attended (if applicable)

I work

Place of Employment

Mothers Name/ Address/ City/ State/Zip, Phone

Fathers Name/Address/City/State/Zip, Phone

References (not a parent)

Reference Name/Address/City/State/Zip, Phone

Reference Name/Address/City/State/Zip, phone

Emergency Contact

Daytime phone Evening phone

relationship

Why did you choose Cosmetology as your career?

How did you hear about EQ?

Will you need financial aid?
yes

no


Have you applied for financial aid?
yes

no


Date you plan to start
February 11, 2008

April 7, 2008

June 16, 2008

August 11, 2008

October 6, 2008

2009


Signature (application will be signed during first visit)Date

I understand that the $50.00 registration fee must be paid before my application will be accepted and that fee will be refunded only if my application is not accepted, or if I cancel my enrollment and request my money back, in writing or in person, within three working days of signing this application.



SCHOOL USE ONLY

Application received

Application fee received

Class

Reference letters mailed

Acceptance letter

Scholarship Award

Current Catalog

Orientation & First Day letter sent

Consumer information given


© Copyright 2008 Craig Mead, All rights reserved.