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Online Request
 
first name
(required)
middle name
last name
(required)
 
Present Street Address City State Zip Code
       
Permanent Street Address City State Zip Code
     
Home Phone (required) Cell Phone Email (required)



Educational Information
 
G.E.D. Date earned
   
High School Graduate  
Name of High School  

Graduation Date  
   
Other Please describe, including dates attended:
   
Vocational/Trade School  
School  
Program/License  
Graduation Date  
If you did not graduate, please indicate years completed.
   
College or university  
School 
Major/Degree  
Graduation Date  
If you did not graduate, please indicate years completed.

1. When would like to begin attending Aveda Institute Chapel Hill?
2. What is your financial plan for school?
   
3. Upon whom are you dependent for more than one half of your financial support?
Parent/Guardian/Spouse Self Other
     
4. Do you plan on working while attending school? Yes      No  
     
5. How did you hear about us?    
Billboard - where? . . . . . . .
Newspaper - which one? . . . . .
Mall - which one? . . . . . . .
Stylist - Who? Which salon? . . .
Web site - which one? Drove/walk by
Other - please specify
Personal Reference
   
Name Relationship Years acquainted
     
 
Street Address City State, Zip Code
     
   
    Telephone

Work Experience/Employment Background
   
 
Employer Company Name Job Title/position From (month-year) - To (month/year)
       
Street Address City State Zip Code Telephone
         
       
Immediate Supervisor        
         
PLEASE do NOT contact my employer.      
         
         
 
Previous Employer Name Job Title/position From (month-year) - To (month/year)
       
Street Address City State Zip Code Telephone
         
       
Immediate Supervisor        


Please explain why you wish to enter the Cosmetology/Beauty industry.
 
What skills or qualities do you currently have that will help you during your cosmetology/esthiology training?
 
How do you plan to utilize your cosmetology/esthiology training?