First Name :

Last Name :

Street Address :

City :

Province/State :

Postal Code/ZIP :

Telephone :

E-mail :

Sex :

Female

Male

Date of Birth :

(dd/mm/yyyy)

Marital Status :

Married

Single

Children :

Yes

No

Physical impairment or illness which could hinder you from exercising
your trade :

How did you hear about our school or our program :

Languages :

english

french

Schooling :

High School

Equivalent

University

College

Program :

Aesthetics

Hairstyling

Gel Nail Technician

Do you want to
receive extra
information on

Map of the town

Housing listing

Canada Student Loans

References in case of Emergency (2):

Reference 1 Information.:

Full Name :

Address :

City :

Telephone :

Relationship :

Reference 2 Information.:

Full Name :

Street Address :

City :

Telephone :

Relationship :

Comments :

The following documents are required with the enrollment application

• Report Card and Diploma
• Recent photo for our file
• Reference Letter
• Copy of Birth Certificate