Applicant Contact Information

First Name*
Last Name:*
Email*
Cell Phone Number:*

By providing your phone number you agree to receive text messages. Message and data rates may apply. Text STOP to opt out or HELP for help

Home Address*
City*
State*
Zip Code*
Country:

Personal Information

Date of Birth*
Social Security #*
Sex:*
Race*
Marital Status*
Are you a permanent resident of the US ?*
If no, Please provide your Alien Registration number:

Education

Are you still attending High School ?*
If no, Please indicate one of the below:*
Name of High School or where you attended GED program*
High School Grad*

LIST BELOW ALL COLLEGES OR POST-SECONDARY SCHOOLS ATTENDED:

Name of College or School
City/State
Year
Degree
Schedule


Name of College or School
City/State
Year
Degree

EMPLOYMENT (IF APPLICABLE):

Employer Name
Date Employed
Position Held
Work Phone
Work Address
Work City
Work State
Work Zip:
Work Country

APPLICATION TYPE

Program of Interest:*
Desired Entrance Date*
Right Handed or Left Handed*

EMERGENCY CONTACT INFORMATION

Emergency Contact Name
Emergency Contact Telephone
Emergency Contact Relationship
What ignited your interest in the beauty industry ?*
What are your future plans and goals?*
How did you heard about Rizzieri ?*

I certify that all of the above is correct to the best of my knowledge.

Initials:*
By submitting this form I consent to the college to contact me by email and text with information about the school and programs. I may withdraw this consent at any time. Message and data rates may apply. Text STOP to opt out or HELP for help.