1. First Name*
2. Last Name*
3. Mobile Phone*
4. Address*
5. City*
6. State*
7. Zip Code*
8. Email address*
9. Facebook Page
10. Twitter Account
11. Instagram Account
12. Name(s) of those most supportive of you pursuing this education
13. Phone number
14. Their relationship to you
15. Name of Graduating High School*
16. Year Graduated*
17. How did you hear about your academy ?*
18. Program of Interest*
19. When did you first become interested in a career in the beuaty industry?
20. Have you visited other beauty schools ?
21. if yes, which ones and when
22. Approximately when would you like to start training ?*
23. Do you have a drivers license ?
24. Have you been able to save money to invest in your education?
25. Are you interested in any other careers ?
26. If yes, please list other careers you are still interested in
27. Have you made arrangements for childcare ?
28. Have you been enrolled in any other schools or colleges since high school ?
29. If you have list each one and when you attended

30. Three (3) goals you would like to accomplish in today

Goal 1
Goal 2
Goal 3