Name
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First Name
Last Name
Date Of Birth
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Social Security Number
*
Physical Address
Email Address
*
Home Phone
(###)
###
####
Cell Phone
(###)
###
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Currently Employed?
If Yes, Where?
Days You Work
Do You Plan To Work While In School?
If so, please list charges and current status.
*
If so, please list charges and current status.
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Your Preferred Appointment Date
MM
DD
YYYY
Preferred School to Attend
*
Marital Status
Race
Number of Dependents
Ages of Dependents
Veteran
If yes, how long?
Level of Education
8
9
10
11
12
Diploma
GED
College
Option Two
Did You Attend Highschool?
If So, What Was the Name of Highschool?
If So, Did You Complete or Drop Out of Highschool?
Did You Attend College?
If So, Did You Complete or Drop Out of College?
If So, What Was the Name of College?
Have You Ever Received Financial Aid Before Today?
Institution Name?
Type of Aid
Aid Amount
Date Received Aid
Previous Years Annual Income
Do Your Parents Claim You On Their Taxes?
If You Have Student Loans, Are They In Good Standing?
Please list the number of hours you have completed at another Barber/Cosmetology School and the date completed.
Please list the reason for not finishing school (please be as detailed as possible).
Which are you?
Why did you choose the barber career?
Do you have any relatives who are barbers?
If Yes, name and relationship
Are there any circumstances (medical, personal, jo, etc) that would interfere with your pursuit of success while attending DeSigner Barber & Stylist School?
If Yes, please explain
(If you become a felon before completion of school, you must notify our office immediately)
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Authorization and School Supplies
*
By clicking "submit" I give permission for DeSigner Barber Academy to run a background check to check for felonies before I begin school. I understand, if admitted, that I do have the right to purchase my own equipment with the exception of the shirts and jacket. If I choose to exercise that right, I understand the tI must have all the equipment purchased and on my person on the first day of school. If I purchase my own supplies and books the charges for items I purchased will not be added to my bill.
