Lansing Application for Admission
125 N. Clippert  :  Lansing, Michigan 48912  :  (517) 333-3232  :  FAX (517) 333-3433
  Name:
 		  Social Security # :
 
Sex* :
  Mailing Address:
 		  Area Code/Phone # :
 
Marital Status* :
  City:
 		  Cell Phone* :

Nbr. of Dependents* :

  State/Zip Code:

  Country* :

Dependent Ages* :
  E-mail: (Valid email required)

  Date of Birth* :


Your Age* :
 
  U.S. Citizen?

  Resident Alien:

 Race/Ethnicity* :


  If No, what Country?

  Non Resident Alien:


* You are not required to give us this information. It is only used for compiling institutional data. It is not a factor in admission decisions.


  Name and Permanent Address of :     Is this also you permanent address?

  Name:
 		  Mailing Address:
  City:
 		  State/Zip:
  Area Code/Phone # :
 		 


Educational Information :
  I plan to enroll in:     Preferred Start Date: (refer to schedule)


PLEASE FORWARD A COPY OF YOUR HIGH SCHOOL TRANSCRIPTS, DIPLOMA, OR GENERAL EDUCATION
DEVELOPMENT CERTIFICATE TO EXCEL ACADEMIES OF COSMETOLOGY IN LANSING, MICHIGAN.


Educational Background :
  Last High School Attended:
 		  Graduation Date (mo/yr):
  City:
 		  State:
  If you did Not Graduate :
  Last school year completed:   Have you received a G.E.D. ?   (mo./yr.)
  School G.E.D. was awarded:
  City:
 		  State:


Schools Attended after High School :
St: Zip:
  Name of School: Address: City: Dates Attended
from to
from to
from to
from to


IMPORTANT :

I certify that all of the information that I have provided on this application is complete and accurate to the best of my knowledge and if admitted, I agree to observe all of the rules and regulations of Excel Academies of Cosmetology.

Name (Signature)      Date

Click below to e-mail this application to the Lansing Excel Academy of Cosmetology.

Print a copy for your records before submitting.