~ PRE-ADMISSIONS INFORMATION FORM ~
Program Of Interest:
Instructor
Cosmetology
Aesthetician
Manicuring
Day/Evening:
Day
Evening
Fist Name:
(required)
Last Name:
(required)
Address:
City:
Country:
State:
Zip:
Day Telephone:
Night Telephone:
Best Time To Contact:
Morning
Afternoon
Evening
Any time
E-mail:
(required)
Gender:
Male
Female
Age:
Start School:
Soon
Now
Education:
No formal education
Less Than High School Graduate
High School Diploma
Trade School
Some College
College Graduate
Graduate School
Other
Do you want loan information:
Yes
No
How did you hear about us:
Please Select
Internet Search
Referral
Newspaper
Radio
Friend/Family
Yellow Pages
<== Please Select
Comments:
(required)