This advance application can be completed and submitted to reserve a space in the class of your

           choice. Please call for further information and to arrange  a personal interview.  You must be at least

           17 years of age to enroll.                                                                                                     

  

       

         PERSONAL INFORMATION

 

        Last Name:    First Name:     M.I. :  

 

        Street Address:    City:  

 

        State:                     Zip:  

 

        Email:     Telephone:  

 

        Cell Phone:        Date of Birth:    

 

        Social Security Number:                                                                                                                                                                                                        

                                            

        CLASS ENROLLMENT

        Classes start five (5) times a year .                                                                                                                                                                                                    

        Please select a preferred enrollment date.      

 

         EDUCATION

       

         Have you graduated  from high school:     Yes         No

 

         High School Attended:             

       

        Graduation Year:     

 

        City:     State:   

 

        If not, have you completed a High School Equivalency Program:     Yes          No

 

         Where completed:  

       __________________________________________________________________________________________            

                                                

                                                         1.  Please  print  completed  page .

 

                                                         2. Mail completed Advance Application to :

 

   Fullen School of Hair Design

1909 Broadway

Scottsbluff, NE 69361

 

Or Call: (308) 632-3731      Toll Free (888) 547-5685

STUDENT OF COSMETOLOGY

ADVANCE ENROLLMENT APPLICATION