Enrollment Form

First Name*

Last Name*

Street Address*

City*

State / Province / Region*

ZIP / Postal Code*

Phone*

Is this a home phone or a cell phone number?*
(Please choose one)HomeCell
May we text message to correspond with you?*
(Please choose one)YesNo
Email Address*

Date of Birth*

What program are you applying for?*
(Please choose one)ESTHETICS (600 hours) DaySPA NAIL PROGRAM (300 hours) DayMASSAGE THERAPY (780 hours) Day

Education Completed*
(Please choose one)High School DiplomaOfficial GED certificateProfessional CertificationProfessional LicensingB.A.B.S.Master’s DegreeHigher

Please upload a copy of high school diploma or transcript with completion/graduation date or GED

Would you be interested in a school payment plan?*
(Please choose one)YesNo

When are you planning to begin classes?*
(Please choose one)0-3 months3-6 months9+ months

Have you applied for financial assistance to pay for program cost?*
(Please choose one)YesNo

How did you hear about our school?*
(Please choose one)WebsiteSocial MediaRadio AdvertisingNewspaper AdvertisingFriendOther (please explain below)

A registration fee of $100.00 (non-refundable) is required before your application is processed. Please contact us to learn forms of payment accepted at 603.625.6100.

If Other above, please explain here:*

By initialing here, you confirm that the above is accurate:*

The school does not discriminate in its employment, admission, instruction, or graduation policies on the basis of sex, age, race, religion, or ethnic origin nor does it recruit students already attending or admitted to another school offering similar programs of study.

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