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(Required) First Name Last Name MAILING ADDRESSMailing Address(Required) Street Address Address Line 2 City State / Province / Region ZIP / Postal Code CountryAfghanistanÅland IslandsAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCôte d'IvoireCroatiaCubaCuraçaoCyprusCzechiaDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRéunionRomaniaRussian FederationRwandaSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTürkiyeTurkmenistanTurks and Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUS Minor Outlying IslandsUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabwe Country Is your Permanent address same as Mailing address ?(Required) Yes No PERMANENT ADDRESSPermanent Address Street Address Address Line 2 City State / Province / Region ZIP / Postal Code CONTACT DETAILSTelephone(Required)Cell PhoneGender(Required) Male Female SOCIAL SECURITY NUMBERSocial Security Number(Required)NEAREST RELATIVERelative NameRelationSelect RelationFatherMotherGuardianSpouse/PartnerRelative's Address Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Have you ever been convicted of a felony ?(Required) Yes No If yes, explain felonyWhich best describes your application status ?(Required) New applicant Former Student Transfer Student If transfer, explainFrom where ?How many hours do you currently have ?(Required)Do you have reliable transportation ?(Required) Yes No If no, explain your plan for getting to and from school(Required)Do you work ?(Required) Yes No If yes, where ?(Required)EDUCATIONAL QUALIFICATIONSList the last high school you attended and your status when you left (i.e. Grad, GED, Withdrew)(Required)High SchoolStatusList all other educational institutions you have or are attending(Required)NameAddressDates AttendedCosmetology School / College Have you been suspended or dismissed from any cosmetology school or college for academic, attendance or disciplinary reasons(Required) Yes No If yes, explain suspension(Required)EMPLOYMENT AND MILITARY HISTORYList your employment experience (including military service) for the last 12 months(Required)EmployerAddressFrom - To ANSWER THE FOLLOWING QUESTIONS IN 3 OR 4 SENTENCES1. Why will you be a great student at our school ?(Required)2. What obstacles might prevent you from achieving excellent attendance and excellent academic performance ?(Required)3. How did you hear about Chic Image Academy ?(Required)4. What traits do you have that will help you succeed in the beauty industry program of choice ?(Required)5. What are your long-term career goals ?(Required)6. Why did you choose Chic Image Academy ?(Required)PROGRAM INFORMATIONWhich education course are you interested in?(Required) 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 PRICELanguage(Required) English Spanish Choose your Weekly Schedule(Required) Part-Time Hybrid Full-Time Hybrid Accelerated Hybrid Part-Time Saturday Hybrid Class Schedule***Note: Check website schedule and confirm on school visit for availability (i.e., once per quarter) This field is hidden when viewing the formAre you interested in remote distance learning? Yes No START DATE(Required) APPROXIMATE END DATE(Required) ***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(Required) 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(Required) 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(Required) I agree to the acceptance policy.I understand that submitting my application does not guarantee acceptance into a program or a place in my selected advanced training courses. Chic Image Academy maintains high standards of professionalism and evaluates each application to support a productive learning environment. This review considers schedule availability, communication style and frequency, interview results, and demonstrated ability to follow directions, research published information, and show a willingness to learn. I understand that my application is valid for 60 days from the date of submission. If my tuition payment is not received within that period, my application will expire and will no longer be valid. If I wish to pursue enrollment after expiration, I must submit a new application using a different email address and undergo a new review based on availability and admissions requirements at that time.CHANGE REQUEST POLICY I agree to the change request policy.I understand that after my admissions interview and before my application is approved, the school and I will agree upon my program, class schedule, language of instruction, and start date. These agreed selections will be reflected in my DocuSign enrollment agreement, which I must sign before my scheduled start date. After I sign my enrollment agreement, any request to change these selections must be formally submitted by email to support@chicimageacademy.com for school approval. If approved, a $50 change request processing fee must be paid before changes are made to my application and enrollment agreement. Requests may be submitted before or after my scheduled start date, but cannot be requested or processed during orientation on my first day. All changes are subject to school approval and current program and scheduling availability. A requested change may require me to restart the admissions process, including submitting updated documentation and obtaining a new review and acceptance based on availability at that time. Until an approved change takes effect, my existing enrollment agreement remains in effect.APPLICATION FEE(Required) Price: Full Name(Required)Date(Required) Signature(Required)Your NameYour NameYour NameYour NameAre you under 18 year of age ?(Required) Yes No Must be 18 or older to submit the application.User RegistrationEmail(Required) Password + Confirm Password(Required) Enter Password Confirm Password This field is hidden when viewing the formApp StatusThis field is hidden when viewing the formApp AmountThis field is hidden when viewing the formApp Status TSThis field is hidden when viewing the formStart Date Changed TSThis field is hidden when viewing the formTuition Paid TSValid government-issued photo IDMax. file size: 128 MB. This field is hidden when viewing the formID StatusThis field is hidden when viewing the formID Received File NameHigh school Diploma/Transcript, GED, or documentation of your highest completed level of educationMax. file size: 128 MB. This field is hidden when viewing the formDiploma StatusThis field is hidden when viewing the formDiploma Received File NameThis field is hidden when viewing the formBypass Upload RequirementsThis field is hidden when viewing the formClear Hidden Fields Δ
