
                

                        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. Note: application cannot be completed without an admissions interview with the Director.
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
Hidden
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?
Hidden
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*
                            
                            MM slash DD slash YYYY
                        
                        
APPROXIMATE END DATE*
                            
                            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 except for the $50 Admissions Fee will be refunded if the school does not accept the applicant. 
 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 $50 Admissions Fee and the $100 Registration Fee (not to exceed $150). 
 Withdrawal after a class has commenced, up to and including  40% Completed Hours of “The Program” will result in a pro-ratedrefund 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 Refund = Total Program Cost  MINUS $50 Admissions Fee MINUS $100 Registration Fee MINUS Books, Materials & other costs issued or used MINUS (Tuition * (Completed Hours / Total Program Hours)) 


Withdrawals after 41% of  Completed Hours 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 
Refund all monies paid by the student. 

Additionally, once the student reaches 40% Completed Hours of “The Program”, the Total Program Cost must be paid in full, and any unpaid balance must be paid to Chic Image Academy before the student can return to school.  If any unpaid balance is not received within 30 calendar days then the student will be withdrawn from the school. 
Student Kits and books once they are issued are not refundable.  

PROGRAM COSTS
TUITION:  $1650.00
REGISTRATION FEE:  $100.00
APPLICATION FOR ADMISSIONS FEE:  $50.00
BOOKS & MATERIALS:  $300.00 (Book, Texts, Kit)
OTHER COSTS:  $400.00 (Supplies)
TOTAL PROGRAM PRICE:  $2500.00
TUITION:  $2475.00 (Promotional price)
REGISTRATION FEE:  $100.00
APPLICATION FOR ADMISSIONS FEE:  $50.00
BOOKS & MATERIALS:  $300.00 (Book, Texts, Kit)
OTHER COSTS:  $50.00 (Supplies)
TOTAL PROGRAM PRICE:  $2975.00
TUITION:  $5975 (Promotional price)
REGISTRATION FEE:  $100.00
APPLICATION FOR ADMISSIONS FEE:  $50.00
BOOKS & MATERIALS:  $300.00 (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 $51.70 non-refundable Admissions Fee. There is a 3.4% processing fee included in the total price. All applications are non-disputable. 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 or email of approval or denial of admission. In the event a prospective student cannot be reached via phone or email, 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 (via 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).
ACCEPTANCE POLICY* I agree to the acceptance policy.
I understand that by submitting my application that I will not be automatically accepted into a program and/or be scheduled for selected advanced training courses.  Chic Image Academy retains a culture of the highest standards and professionalism and in order to provide the best atmosphere for learning success, the application process includes assessing criteria that is essential to ensuring a good fit which includes schedule availability, communications style and frequency, interview results, and demonstrated abilities to follow directions, research and find already published answers, and express a willingness to learn.  
APPLICATION FEE*
					
					
						Price:
						
					
					
				
Name* 
Date*
                            
                            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*
                            
                        
Password*
						
							
							
							
							
							Enter Password
						
						
							
							
							
							
							Confirm Password
						
						
					
          
            
            
            
            
            
            
            
            
            
        
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