
                

                        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
Gender*Male
Female
SOCIAL SECURITY NUMBER
Social Security Number*
NEAREST RELATIVE
Relative Name
Relation
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 ?*
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 ?*
PROGRAM INFORMATION
Which education course are you interested in?*Facial Specialist
Nail Specialist
Makeup Artistry and Facial Specialist
Not interested in a licensed course at this time
CLOCK HOURS: 260 HOURS
CLOCK HOURS: 240 HOURS
CLOCK HOURS: 520 HOURS
Are you interested in any Advanced Education Courses?
								
								Lash Lift Training +$350.00
							

								
								Dermaplane +$385.00
							

								
								Micro Needling aka Collagen Induction Therapy +$1,050.00
							

								
								Brow Lamination +$450.00
							

								
								Advanced Technology Microdermabrasion Training +$475.00
							

								
								Chemical Peels Training +$275.00
							

								
								Facial Cupping Training +$275.00
							

								
								Bikini and Brazilian Waxing +$475.00
							

								
								Body Sculpting +$675.00
							

								
								Makeup Certification +$1,250.00
							

								
								Plamere Plasma Training +$2,900.00
							
Language*English
Spanish
Do you plan to be a*Full-time student (40 - 55 hours)
Part-time student (15 - 39 hours)
Accelerated (56 hours)
What is the minimum number of hours per week you'd like to take?
Are you interested in remote distance learning?*Yes
No
Which schedule are you interested in ?*Tuesday - Friday (4 days)
Tuesday - Saturday (5 days)
Monday - Saturday (6 days)
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Add Custom Time 
Total hours: /
Warning: You have exceeded or have less than total hours. 
Please reduce or increase the hours. 
 You can select Full-time, Part-time or Accelerated to change total hours.
START DATE*
                            
                            Date Format: MM slash DD slash YYYY
                        
                        
APPROXIMATE END DATE*
                            
                            Date Format: MM slash DD slash YYYY
                        
                        
***Note: The Student must begin class on the speciﬁed Start Date listed in this Enrollment Agreement, unless prior approval
has been given by the Director, in writing, and a new Start Date has been designated.
DIPLOMA WILL BE AWARDED UPON COMPLETION OF THE PROGRAM.
CANCELATION AND REFUND POLICY
Refunds, when due to a student will be made according to the following terms. Students must acknowledge acceptance of these terms when they sign an Enrollment Agreement.

Withdrawals must be made in person or by certiﬁed mail.
All monies paid will be refunded if the school does not accept.
All monies paid will be refunded if the student withdraws within three (3) working days after signing the Enrollment Agreement.
Withdrawals that occur after three (3) working days of signing the Enrollment Agreement, but before the first day of class, will result in a full refund of all monies paid, minus the registration fee and fees for books, supplies and materials.
Withdrawal after a class has commenced, up to and including 40% completion of “The Program” will result in a pro-rated refund of the Total Program Cost, assuming that the Total Program Cost was paid in full by the student prior to withdrawal.

Refund calculation are based on the following formula:
Total Program Cost (minus registration fee and books, materials, supplies) multiplied by percent of Program completion, which is derived by dividing the number of completed hours into total program hours. That amount is then deducted from the Total Program Cost to determine the refund.

Withdrawals after completing 41% of “The Program” will result in NO REFUND. Additionally, any remaining unpaid balance from the student will be considered due immediately, and the student will be held contractually responsible for paying that amount to Chic Image Academy.
The Termination Date used for calculating refunds is the last date of actual attendance by the student, the last day of attendance if written notification is provided to the school by the student, or from the date the school determines withdrawal by a student or terminates a student.
Refunds, when due, will be made within 30 days of the Termination Date
Program/course cancellations & refunds

If the school cancels a program or course, or changes its curriculum, while the student has a signed Enrollment Agreement with the school, then the school will either:
Complete the training of the student at no additional cost
Attempt to make other arrangements for the student (i.e., transfer the student to another program offered by the school
Or refund all monies paid by the student.


Additionally, if a student fails to pay in full the Total Program Cost up to and including 40% of “The Program” the student may be terminated/dismissed from the school, AND any unpaid balance will be considered due in full to be paid immediately to Chic Image Academy. All costs must be paid before reaching 41% of the total clock hours of the chosen program unless a payment plan has been established
PROGRAM COSTS
TUITION:  $1500.00
REGISTRATION FEE:  $100.00
APPLICATION FOR ADMISSIONS FEE:  $50.00
BOOKS & MATERIALS:  $450.00 (Book, Texts, Kit)
OTHER COSTS:  $400.00 ( Supplies)
TOTAL PROGRAM PRICE:  $2500.00
TUITION:  $3950.00-$1975.00 = $1975
REGISTRATION FEE:  $100.00
APPLICATION FOR ADMISSIONS FEE:  $50.00
BOOKS & MATERIALS:  $450.00 (Book, Texts, Kit)
OTHER COSTS:  $400.00 ( Supplies)
TOTAL PROGRAM PRICE:  $2975.00
TUITION:  $5975.00
REGISTRATION FEE:  $100.00
APPLICATION FOR ADMISSIONS FEE:  $50.00
BOOKS & MATERIALS:  $450.00 (Book, Texts, Kit)
OTHER COSTS:  $400.00 ( Supplies)
TOTAL PROGRAM PRICE:  $6825.00
REFUND POLICY* I agree to the refund policy.
By submitting payment I consent and agree to the cancelation and refund policy stated below.  I also agree to initial and sign the enrollment agreement which will be sent immediately upon payment to my email address which includes all of the information in my application for admissions.
ADMISSION POLICY* I agree to the admission policy.
Submit 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
APPLICATION FEE*
					
					Price: $51.50
					
					
				
Name*
Date*
                            
                            Date Format: MM slash DD slash YYYY
                        
                        
Signature*
Are you under 18 year of age ?*Yes
No
Must be 18 or older to submit the application.
User Registration
Email*
                            
                        
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