ADMISSION FORM

I Plan to Start School In    January February March April May June July August September October November December

I will attend      DAYS    or    NIGHTS

Married    Single    Divorced

Mrs.    Miss.    Mr.

First Name                  

Middle Name               

Last Name                  

Your Home Address    

City     State     Zip  

Phone Number                Cell/Other Phone Number  

Your Email Address    

S. S. Number             

Drivers Licence Number    

Date Of birth     January February March April May June July August September October November December   /     /  

Your Age               Number of Children    

Please select your ethnic origin
Black
American Indian
Asian
Hispanic
White
Unknown

Your Place Of Employment    

Your Employers Address       

City         State         Zip    

Employers Phone Number    

Your Spouse's Name                             

Your Spouse's Place Of Employment    

Your Father's Name                             

Your Father's Place Of Employment    

Your Father's Address                         

City         State         Zip    

Father's Phone Number    

Your Mother's Name                             

Your Mother's Place Of Employment    

Your Mother's Address                         

City         State         Zip    

Mother's Phone Number    

LIST BELOW THE SCHOOLS YOU ATTENDED    

                                   Name of School                          Dates Attended                         Date of Graduation

High School         

College                

College                

Have you visited Vernon's    
No
Yes

If YES when    

How do you plan to finance your education?    
Pell
Student Loans
Cash Payment Plan

Check here if you would like Financial Aid Information.    

Check here if you would like Institutional Grant Information.    

Are you a veteran?    
Yes
No

If YES what service branch?     Please Choose One Army Air Force Navy Marines Coast Guard

Are you eligible for Veteran's Educational Benefits?    
Yes
No

If YES what is the location of Records       &

What is your Selective Service Number   

Where did you learn about Fayetteville Beauty College? (check all that apply)
Fayetteville Beauty College Graduate
Yellowpages
News Paper
Radio
TV
Friend
High School Counselor
Salon Owner

What high school activities did you participate in? (check all that apply)
Musical
Forensics ( speech, drama, debate )
Athletics
Class officer
Yearbook, newspaper
Organizations (PEP club. Etc )

I hereby apply for acceptance in the program of study checked
Cosmetology      Manicuring

APPLICATION STATEMENT
I am applying for admission to the program checked above. Vernon's will carefully consider all of the information provided in making its decision about your enrollment. In making this application I have been made aware of the employment opportunities in the field, compensation plans, physical demands, safety requirements, licensing requirements, the school's pass/fail rates, completion rates and placement rates.

I agree to abide by the rules and regulations of the school, as defined in the brochure of Vernon's Kansas School of Cosmetology, a copy of which I have been provided. I understand and agree that Vernon's has the right to make changes in connection with any subject described in its brochure including: curriculum, course content, class schedule, faculty, training equipment, tuition rates, and fees as it deems appropriate. I further agree that the school has the right to make such changes without notice to me at any time, even after I have begun a program of study. Enrollment is limited! If you wish to assure space in the class of your choice an administrative fee of $100 should accompany this application. If you are not accepted, into the program of your choice, the admission fee will be refunded.