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 NAMEName* First Name Last Name MAILING ADDRESSMailing Address* Dirección Dirección 2 Ciudad Estado / Provincia / Región ZIP / Código Postal CountryAfghanistánAlbaniaAlemaniaAndorraAngolaAnguillaAntigua y BarbudaAntártidaArabia SauditaArgeliaArgentinaArmeniaArubaAustraliaAustriaAzerbaiyánBahamasBangladeshBarbadosBaréinBeliceBeninBermudaBhutánBielorusiaBoliviaBonaire, San Eustaquio y SabaBosnia y HerzegovinaBotswanaBrasilBrunei DarussalamBulgariaBurkina FasoBurundiBélgicaCabo VerdeCamboyaCamerúnCanadaChadChequiaChileChinaChipreColombiaComorasCongoCongo, República Democrática delCorea, República Popular Democrática deCorea, República deCosta RicaCosta de MarfilCroaciaCubaCurazaoDinamarcaDjiboutiDominicaEcuadorEgiptoEl SalvadorEmiratos Árabes UnidosEritreaEslovaquiaEsloveniaEspañaEstados UnidosEstoniaEsuatiniEtiopíaFederación RusaFijiFilipinasFinlandiaFranciaGabónGambiaGeorgiaGhanaGibraltarGranadaGreciaGroenlandiaGuadalupeGuamGuatemalaGuayanaGuayana FrancesaGuernseyGuineaGuinea BissauGuinea EcuatorialHaitíHondurasHong KongHungríaIndiaIndonesiaIraqIrlandaIránIsla BouvetIsla NorfolkIsla de ManIsla de NavidadIslandiaIslas CaimánIslas CocosIslas CookIslas FaroeIslas Heard y McDonaldIslas MalvinasIslas Marianas del NorteIslas MarshallIslas SalomónIslas Turcas y CaicosIslas Ultramarinas Menores de Estados UnidosIslas Vírgenes BritánicasIslas Vírgenes de los Estados UnidosIslas ÅlandIsraelItaliaJamaicaJapónJerseyJižní Georgie a Jižní Sandwichovy ostrovyJordánKazajistánKeniaKirguistánKiribatiKuwaitLIbiaLesotoLiberiaLiechtensteinLituaniaLituaniaLuxemburgoLíbanoMacauMacedonia del NorteMadagascarMalasiaMalawiMaldivasMaliMaltaMarruecosMartinicaMauricioMauritaniaMayotteMicronesiaMoldaviaMonacoMongoliaMontenegroMontserratMozambiqueMyanmarMéxicoNamibiaNauruNepalNicaraguaNigeriaNiueNoruegaNueva CaledoniaNueva ZelandaNígerOmánPaises BajosPakistánPalauPalestina, Estado dePanamáPapúa Nueva GuineaParaguayPerúPitcairnPolinesia FrancesaPoloniaPortugalPuerto RicoQatarReino UnidoRepública CentroafricanaRepública Democrática Popular de LaosRepública DominicanaRepública Árabe de SiriaReuniónRuandaRumaníaSahara OccidentalSamoaSamoa AmericanaSan BartoloméSan Cristóbal y NievesSan MarinoSan MartínSan Pedro y MiquelónSan Vicente y las GranadinasSanta Elena, Ascensión y Tristán de AcuñaSanta LucíaSanta SedeSanto Tomé y PrincipeSenegalSerbiaSeychellesSierra LeonaSingapurSint MaartenSomaliaSri LankaSudáfricaSudánSudán del SurSueciaSuizaSurinamSvalbard y Jan MayenTailandiaTaiwanTanzania (República Unida de)TayikistánTerritorio Británico del Océano ÍndicoTierras Australes y Antárticas FrancesasTimor OrientalTogoTokelauTongaTrinidad y TobagoTurkmenistánTurquíaTuvaluTúnezUcraniaUgandaUruguayUzbekistánVanuatuVenezuelaVietnamWallis y FutunaYemenZambiaZimbaue País Is your Permanent address same as Mailing address ?* Yes No PERMANENT ADDRESSPermanent Address Dirección Dirección 2 Ciudad Estado / Provincia / Región ZIP / Código Postal CONTACT DETAILSTelephone*Cell PhoneGender* Male Female SOCIAL SECURITY NUMBERSocial Security Number*NEAREST RELATIVERelative NameRelationSelect RelationFatherMotherGuardianSpouse/PartnerRelative's Address Dirección Dirección 2 Ciudad Estado / Provincia / Región ZIP / Código Postal Have you ever been convicted of a felony ?* Yes No If yes, explainWhich best describes your application status ?* New applicant Former Student Transfer Student If transfer, explainFrom 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 QUALIFICATIONSList the last high school you attended and your status when you left (i.e. Grad, GED, Withdrew)*High SchoolStatusList all other educational institutions you have or are attending*NameAddressDates AttendedCosmetology 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 HISTORYList your employment experience (including military service) for the last 12 months*EmployerAddressFrom - To ANSWER THE FOLLOWING QUESTIONS IN 3 OR 4 SENTENCES1. 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 INFORMATIONWhich education course are you interested in?* Facial Specialist Nail Specialist Makeup Artistry and Facial Specialist Electrology and Laser Massage Therapy Facial Specialist - Intermediate Certifications Facial Specialist - Advanced Clinical Certifications Nail Specialist - Advanced Certifications Program Total HoursPractical Hours (Hands On/In Person)PROGRAM COSTSTUITIONREGISTRATION FEEADMISSIONS FEEBOOKS & MATERIALSOTHER COSTSTOTAL PROGRAM PRICEEste campo está oculto cuando se visualiza el formularioAre you interested in any Advanced Education Courses?Language* English Spanish Choose your Weekly Schedule* Part-Time Hybrid Full-Time Hybrid Accelerated Hybrid Class Schedule***Note: Check website schedule and confirm on school visit for availability (i.e., once per quarter) Este campo está oculto cuando se visualiza el formularioAre you interested in remote distance learning? Yes No START DATE* MM barra DD barra AAAA APPROXIMATE END DATE* MM barra DD barra AAAA ***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 POLICYRefunds, 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. 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* Precio: Name*Date* MM barra DD barra AAAA Signature*Are you under 18 year of age ?* Yes No Must be 18 or older to submit the application.User RegistrationEmail* Password* Introduce la constraseña Confirmar contraseña Este campo está oculto cuando se visualiza el formularioApp StatusEste campo está oculto cuando se visualiza el formularioApp AmountEste campo está oculto cuando se visualiza el formularioApp Status TSEste campo está oculto cuando se visualiza el formularioStart Date Changed TSEste campo está oculto cuando se visualiza el formularioTuition Paid TS Δ
