Online Scholarship Application Process - Electrolysis, Electrology, School, Schools, Permanent Make Up, Permanent Cosmetics, Program

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Scholarship Application - American Institute Of Education

Note: Required fields are marked with an asterisk (*)

Personal Data

First Name *

Last Name *

Middle Initial

Street Address *

E-Mail

City *

Phone * - -

State *

Zip Code *

Date Of Birth * / /

mm / dd / yyyy

Sex *

Citizenship * US Alien No. A- Other

Handicap that may affect your job limitations, if any:

Marital Status *

No. Dependant Children *

Are you their sole provider?

Are you a US Veteran? *

Housing During Enrollment *

Educational Data

Diploma, Certificate or Degrees earned that are equivalent and recognized by the United States educational system.

HIGH SCHOOL: (Please read carefully. If needed, use AACRAO for reference in recognized educational levels)

Check this box ONLY if you have completed U.S. High School or its equivalent

If you have not completed High School or its equivalent, provide last U.S. equivalent grade completed:

Certificate, Diploma or Degrees earned by the applicant: (Check as many as applicable)

Last High School Attended *

Graduation Date * / /

mm / dd / yyyy

Financial Aid History

Have you received financial aid?

If yes, have you owed a refund or defaulted on a loan?

Employment Experience

Name of current or prior employer: *

Employed From * to

mm / yyyy

Employment Address *

Pay rate: ($)* per

City *

State *

Zip Code *

Family Data And Emergency Contact

Father

Name

Address

City

State

Zip Code

Phone - -

Mother

Name

Address

City

State

Zip Code

Phone - -

Personal Reference

Name *

Address *

City *

State *

Zip Code *

Phone * - -

Financial Information

Please list your monthly overhead by the following categories (total per month):

Rent / Mortgage *

Auto Payment *

Child Support *

Health Insurance *

Other Tuition *

Consumer Loan Payments *

Credit Card Payments *

Miscellaneous *

Additional Info

How did you hear about our school?

Referred By

You will be enrolling in an electrology program. How soon would you be able to start school? * / /

mm / dd / yyyy

You plan on enrolling*

Have you ever been convicted of a felony?*

Females: Are you expecting? (Job Hazards)*

Work And Interests

You are more interested in

You prefer to read

If other, describe:

Exercise: Favorite physical activity:

Past Work Experience: If you have ever been self-employed, briefly tell us about your time as a business owner.

List any other work experience that might be relevant to an electrology practice.

Tell us in a couple of paragraphs at most, why you believe you would succeed as a Licensed Electrologist.

Enter Black Symbols in Box

ONLY the 3 BLACK symbols which are case sensitive. There are no Zeroes.