Online Enrollment Application - Academy of Hair Design

Name

This field is for validation purposes and should be left unchanged.

Program Information

Please select the program of interest and the month you would like to start training.

Campus*

Program of Interest*

When would you like to begin your studies?*

When would you like to schedule your tour?

Let us know what day and time would work best for you

Are you interested in full or part-time classes?*

Full-Time

Part-Time

Class Time*

AM

PM

Are you interested in financial aid?*

Yes

No

Personal Information

Name*

Nickname

Date of Birth*

Sex*

Ethnicity*

Phone*

Email*

Are you left or right-handed?*

Address*

References

Please list three (3) people whom you have known at least one year:

Reference #1

Name*

Phone*

Email

Relationship*

Reference #2

Name*

Phone*

Email

Relationship*

Reference #3

Name

Phone*

Email

Relationship*

Legal Disclaimer

Before you take the licensing test, the state may need to check your background and criminal record. Have you ever been convicted of a felony in the last 10 years?*

Yes

No

If this is any cause of concern for you, please feel free to reach out so we can help you through the process of becoming licensed.

Applicant Signature*

Today's Date*

How did you hear about us?*

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Make Your Dreams a Reality.

Program Information

Personal Information

Education

Additional Education

References

Reference #1

Reference #2

Reference #3

Legal Disclaimer

Get In Touch

Springfield

About Us

More Information

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Get In Touch

Springfield

About Us

More Information

Stay Connected

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