New Beaver Beauty Academy Application

Beaver Beauty Academy Application

About You

First Name

Last Name

Birth Date

Cell Phone

Home Phone

Street

City

State/Province

Zip/Postcode

VA Student

Yes No Not Selected

Social Security No

Please Upload High School Diploma,GED, or Transcripts

Please Upload Drivers License or State ID

Program Information

Campus

Program

Program Start Date

Class Schedule

Uniform Shirt Size

Emergency Contact Information

Emergency Contact

Phone

Relationship

Street

City

State/Province

Zip/Postcode

Student Certification

The State License Department may require a background and criminal record check prior to a licensing test. Do you have any incidents in your past that may cause concern?

Yes No Not Selected

Have you attended a Beauty Insituition Before:

Yes No Not Selected

If Yes, Please explain why you left:

Applicant Signature

Today's Date

Student Personal History

Briefly tells us why you should be considered for acceptance to Beaver Beauty Academy

Highest level of education completed

Ethnicity

Gender

Status

Are you Head of Household

Yes No Not Selected

How Many Children Do You Have?

How Many Miles Do You Live From School

Type of Housing

Demographic Area

Marital Status

Citizenship

Payment Information

Items	Amount
Tuition	$0.00
Total	$0.00

Payment Method

Required

Phone Number

Required

Card Holder Name

Required

Card Holder ID / RIF

Required

Credit Card Number

Required

Expiration Date

Required

Security Code

Required

Currency

USD

Account Number

Required

Routing Number

Required

Enter the above code

Required