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Application for Enrollment

House of Elegance Cosmetology School — Application for Prospective Students and Enrollment. Complete all sections below. We are excited to offer you the opportunity to explore your passion and skills in the beauty industry through our Cosmetology or Barber program.

Section 1: Personal Information

Last Name*

First Name*

Middle Initial

Address*

City*

State*

ZIP Code*

Date of Birth*

Month

Day

Year

Age

Sex

Ethnicity

Marital Status

Social Security Number

ID or Driver's License Number

ID/DL Issuing State

Email Address*

Mobile Phone*

Work Phone

Home Phone

Section 2: Program

Program of Interest*

Cosmetology Program

Barber Program

Current Level of Skill*

No prior experience, but eager to learn

Some experience (practicing on friends/family, self-taught skills)

Formal training or classes

Other

If you selected formal training or other, please specify

Section 3: About You

Relevant Background*

Please provide any relevant experiences, interests, or hobbies that relate to beauty, hair, or personal care

What inspired you to pursue a career in the beauty industry?*

How do you plan to use the skills you learn in the program in the future?*

What are your long-term career goals, and how can our program help you achieve them?*

Tell us why you believe you will make a good Cosmetologist*

Tell us what you expect to obtain from attending school at House of Elegance Cosmetology School*

Section 4: Education and History

How did you hear about us?

Do you have a High School Diploma?*

Yes

No

High School Name

High School City

High School State

Year of Graduation

Do you have a GED?*

Yes

No

GED Year Received

Have you ever had any Cosmetology Related Courses before?*

Yes

No

If so, When?

How many hours did you clock?

What Cosmetology related course were you in?

Have you ever been convicted of a Felony?*

Yes

No

If yes, please explain

Do you have any disabilities?

Yes

No

Prefer not to answer

If yes, please explain

Section 5: Employment

Last place of Employment

Are you still working?

Yes

No

Job Title

Are you planning to work part-time while attending school?*

Yes

No

Section 6: Emergency Contact and Relatives

Emergency Contact Name*

Emergency Contact Phone*

Emergency Contact Address

Emergency Contact City

Emergency Contact State

Emergency Contact ZIP

Doctor’s Name*

Doctor’s Telephone*

Relative 1 Name

Relative 1 Relationship

Relative 1 Address

Relative 1 City

Relative 1 State

Relative 1 ZIP

Relative 1 Telephone

Relative 2 Name

Relative 2 Relationship

Relative 2 Address

Relative 2 City

Relative 2 State

Relative 2 ZIP

Relative 2 Telephone

Section 7: Certification

I certify that all of the information provided on this form is true and complete to the best of my knowledge.

I agree to the certification above

Applicant Full Name*

Date*

Month

Day

Year

Application Fee

$50

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