Application - Chic Image Academy


                

                        APPLICATION FOR ADMISSIONS CHIC IMAGE ACADEMY 

Please complete and submit the entire application. Incomplete applications will be returned to you and
will delay the decision on your acceptance. 
FULL NAME
Name*
                            
                            
                                                    
                                                    First Name
                                                
                            
                            
                                                    
                                                    Last Name
                                                
                            
                        
MAILING ADDRESS
Mailing Address*    
                    
                         
                                        
                                        Street Address
                                    
                                        
                                        Address Line 2
                                    
                                    
                                    City
                                 
                                        
                                        State / Province / Region
                                      
                                    
                                    ZIP / Postal Code
                                
                    
                
Is your Permanent address same as Mailing address ?*Yes
No
PERMANENT ADDRESS
Permanent Address*    
                    
                         
                                        
                                        Street Address
                                    
                                        
                                        Address Line 2
                                    
                                    
                                    City
                                 
                                        
                                        State / Province / Region
                                      
                                    
                                    ZIP / Postal Code
                                
                    
                
CONTACT DETAILS
Telephone*
Cell Phone
Email*
                            
                        
Gender*Male
Female
NEAREST RELATIVE
Father*
                            
                            
                                                    Father
                                                    
                                                
                            
                            
                            
                        
Mother*
                            
                            
                                                    Mother
                                                    
                                                
                            
                            
                            
                        
Guardian*
                            
                            
                                                    Guardian
                                                    
                                                
                            
                            
                            
                        
Spouse / Partner*
                            
                            
                                                    Spouse / Partner
                                                    
                                                
                            
                            
                            
                        
Relative's Address*    
                    
                         
                                        
                                        Street Address
                                    
                                        
                                        Address Line 2
                                    
                                    
                                    City
                                 
                                        
                                        State / Province / Region
                                      
                                    
                                    ZIP / Postal Code
                                
                    
                
Have you ever been convicted of a felony ?*Yes
No
If yes, explain
Which best describes your application status ?*New applicant
Former Student
Transfer Student
If transfer, explain
From where ?
How many hours do you currently have ?*
When would you like to begin classes ?*
Which education course are you interested in?*
								
								Facial Specialist
							

								
								Nail Specialist
							

								
								Makeup Artistry and Facial Specialist
							

								
								Professional Advanced Education Course
							

								
								Other
							
Do you plan to be a*Full-time student
Part-time student
Which schedule are you interested in ?*Day
Evening
Do you have reliable transportation ?*Yes
No
If no, explain your plan for getting to and from school*
Do you work ?*Yes
No
If yes, where ?*
EDUCATIONAL QUALIFICATIONS
List the last high school you attended and your status when you left (i.e. Grad, GED, Withdrew)*High School Status
List all other educational institutions you have or are attending*Name Address Dates Attended Cosmetology School / College  
      
Have you been suspended or dismissed from any cosmetology school or college for academic, attendance or disciplinary reasons*Yes
No
If yes, explain*
EMPLOYMENT AND MILITARY HISTORY
List your employment experience (including military service) for the last 12 months*Employer Address From - To  
      
ANSWER THE FOLLOWING QUESTIONS IN 3 OR 4 SENTENCES
1. Why will you be a great student at our school ?*
2. What obstacles might prevent you from achieving excellent attendance and excellent academic performance ?*
3. How did you hear about Chic Image Academy ?*
4. What traits do you have that will help you succeed in the beauty industry program of choice ?*
5. What are your long-term career goals ?*
6. Why did you choose Chic Image Academy ?*
ADMISSION POLICY* I agree to the admission policy.
Application along with a $50 non-refundable application Fee. All applications will be reviewed and approved by the Academy’s Director, Admissions Representative or Manager .Incomplete applications will not be considered for review. Applications received from an applicant with a felony conviction will be further reviewed by the schools’ owner, directors’  or staff,  campus Admissions Representative or Manager. Submitting an application does not guarantee admission. Prospective students will be notified by phone of approval or denial of admission and/or email. In the event a prospective student cannot be reached via phone, a letter will be mailed to the address provided on the Admissions Application.



Chic Image Academy reserves the right to approve or deny admission based on information gathered from the Admissions Application, during conversations with prospective students or friends and family members of prospective students (on the phone or in person), letters written by or on the behalf of a prospective student, or any other form of communication. Chic Image Academy teaches all courses in English and Spanish.



I certify that to the best of my knowledge, the information given in this application is true.  I understand that any omission or misrepresentation of facts will be cause for refusal of admission, cancellation of application, or dismissal from Chic Image Academy if later discovered.  I further understand that, if I am approved and accepted into the program, it is MY RESPONSIBILITY to arrange for ALL ADMISSION CREDENTIALS (diploma, official transcripts, down payment, etc.) to be received by the Admissions Office AT THE TIME OF MY ENROLLMENT.( You will not be allowed to start classes until all admission process is complete
Name*
Date*
                            
                            Date Format: MM slash DD slash YYYY
                        
                        
Signature*
Are you under 18 year of age ?*Yes
No
Parent’s or Guardian’s Name and Signature is required
Parent / Guardian Name*
Date
                            
                            Date Format: MM slash DD slash YYYY
                        
                        
Parent / Guardian Signature*
Payment Details
Applicable Fee ($50 + 3% processing fee)
					
					Price: $51.50
					
					
				
Pay using*PayPal
Stripe
Cash
Credit Card*
						
							
							
							Card Details
						
						
							
							Cardholder Name