Course for which you are applying *

The following sections are available (choose one):

June 2024

Name *

First Name

Last Name

Mailing Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Cell phone number *

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Birthdate *

You must be 18 years of age to be admitted to the Basic Course unless we receive written permission from a parent or guardian in advance.

MM

DD

YYYY

Cosmetology/Esthetics

Please let us know if you have completed programs in either of the following areas:

Cosmetology

Aesthetics