Application Date:
Name:
Address:
Phone:
-
Cell Phone:
-
E-mail:*
Highest Level of Education:
I have a:
Name / City / State of College Attended (if applicable):
I work:
Place of Employment (if applicable):
Mother's Name
Address
City, ST Zip
Phone Number
Father's Name
Address
City, ST Zip
Phone Number

References (not a parent)

Reference Name
Address
City, ST Zip
Phone Number
Reference Name
Address
City, ST Zip
Phone Number
Emergency Contact
Name
Daytime Phone
Evening Phone
Relationship
Why did you choose Cosmetology as your career?
How did you hear about EQ School of Hair Design?
Will you need financial aid?
Have you applied for financial aid?
Date you plan to start:
Electronic Signature:
(form will be signed in person at the school)
*
Let us know you're a live human being! :-)




For Office Use Only:

_____ Application Recived

_____ Application Fee Received

_____ Class

_____ Reference Letters Mailed

_____ Acceptance Letter

_____ Scholarship Award

_____ Current Catalog

_____ Orientation & First Day Letter Sent

_____ Consumer Information Given