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Did you graduate?
Yes
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What year did you graduate?
How many years did you complete?
Course of Study
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Yes
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Phone
Did you graduate?
Yes
No
What year did you graduate?
How many years did you complete?
Course of Study
Degree/Certificate
Program
Program
Please select the desired program.
Esthetics
Master Esthetics
Start Date
What is the Start Date of your desired program?
MM slash DD slash YYYY
Licensure And Certification
Have you ever cancelled enrollment in or been terminated from an educational or training program?
No
Yes
Please explain
Have you ever been licensed or certified?
Yes
No
By what organization?
From what organization did you receive your license or certification?
Address
Street Address
Address Line 2
City
State / Province / Region
ZIP / Postal Code
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bonaire, Sint Eustatius and Saba
Bosnia and Herzegovina
Botswana
Bouvet Island
Brazil
British Indian Ocean Territory
Brunei Darussalam
Bulgaria
Burkina Faso
Burundi
Cabo Verde
Cambodia
Cameroon
Canada
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos Islands
Colombia
Comoros
Congo
Congo, Democratic Republic of the
Cook Islands
Costa Rica
Croatia
Cuba
Curaçao
Cyprus
Czechia
Côte d'Ivoire
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Eswatini
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Guiana
French Polynesia
French Southern Territories
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Heard Island and McDonald Islands
Holy See
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Isle of Man
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
Korea, Democratic People's Republic of
Korea, Republic of
Kuwait
Kyrgyzstan
Lao People's Democratic Republic
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macao
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
North Macedonia
Northern Mariana Islands
Norway
Oman
Pakistan
Palau
Palestine, State of
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn
Poland
Portugal
Puerto Rico
Qatar
Romania
Russian Federation
Rwanda
Réunion
Saint Barthélemy
Saint Helena, Ascension and Tristan da Cunha
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Sint Maarten
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Georgia and the South Sandwich Islands
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard and Jan Mayen
Sweden
Switzerland
Syria Arab Republic
Taiwan
Tajikistan
Tanzania, the United Republic of
Thailand
Timor-Leste
Togo
Tokelau
Tonga
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Tunisia
Turkmenistan
Turks and Caicos Islands
Tuvalu
Türkiye
US Minor Outlying Islands
Uganda
Ukraine
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United Kingdom
United States
Uruguay
Uzbekistan
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Venezuela
Viet Nam
Virgin Islands, British
Virgin Islands, U.S.
Wallis and Futuna
Western Sahara
Yemen
Zambia
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Åland Islands
Country
Phone
Has your license or certification ever been revoked or suspended?
No
Yes
Please explain, including current litigation, if any.
Have you ever been convicted of a felony or misdemeanor?
No
Yes
Please explain, including current litigation, if any.
Health
Please explain any care you have received from a medical doctor, holistic practitioner, psychotherapist or counselor.
Please describe your physical, emotional and mental health.
Please explain any hospitalizations, institutionalizations or prescription medications for illness.
Excluding antibodies, please detail any prescription medications taken in the last 2 years.
Do you have or have you had any communicable diseases or conditions within the past 2 years that affect giving or receiving esthetic services?
Yes
No
Please describe any communicable diseases or conditions within the past 2 years that affect giving or receiving esthetic services.
Do you have any history of substance abuse?
No
Yes
Please describe any substance abuse, including recovery or rehab programs and specific dates of abuse and (ongoing?) recovery:
Supporting Documents
Brief Biological Sketch
Brief description of yourself from a “Best-Friend” perspective
Recent Photo
Passport Picture with white background
Accepted file types: jpg, png, pdf, Max. file size: 100 MB.
Your High School Diploma, GED and/or College Transcripts
Please scan a copy or copies of your documents and upload here.
Drop files here or
Select files
Max. file size: 32 MB.
Agreement
*
I have completed this application to the best of my knowledge and state that the information I have given is true and correct.
I furthermore agree to comply with the institute’s policy that I will not attend classes or perform sessions under the influence of drugs or alcohol.
I agree to these statements.
Registration Fee
*
The registration fee must be paid in full before this admissions application can be processed.
I will provide the $50 Registration Fee.
CAPTCHA
Phone
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