Enrollment Application

Next Level Enrollment Application

Personal Information

First Name

Last Name

Address

Address Line 1

Address Line 2

City

State

Zip Code

Country

Work Phone Number

Cell Phone Number

Date of Birth

Marital Status

Maiden Name

Child/Children?

Yes

Are You Employed?

Yes

Emergency Contact

First Name

Last Name

Contact Number

Relationship to Contact 1

First Name

Last Name

Contact Number

Relationship to Contact 2

Course of Study

Select the license course(s) of study that you are interested in enrolling for.

Natural Hair and Braiding Course (300 hours)

Natural Hair and Braiding Instructor Course (500/600 hours Program)

Nail Technology Course (350 hours/Bridge Program)

Nail Technology Instructor Course (500/625 Hours/Bridge Program)

Cosmetology Course (1500 hours/Bridge Program)

Cosmetology Instructor Course (500/1000 Hours/Bridge Program)

Barber Course (1500 hours/Bridge Program)

Barber Instructor Course (500/1000 Hours/Bridge Program)

Refresher Course Hours

Education Level of Completion

Which High School did you Graduate from?

High School Graduation Year

Certification

GED

Diploma

Did you attend a trade school?

Yes

List the trade school name you attended and which specialty did you study.

Did you complete your trade school program?

Yes

Did you attend a College or University?

List the College or University School Name you attended and what you majored in.

Did you graduate from a College or a University?

Yes

Name of Referral Person

Background

Have you ever been convicted of a misdemeanor or a felony?

YES

If yes please explain.

Financial Options

How do you plan to pay for your tuition?

If other,

WorkNet Funding Applications can take up to two months for completion of the enrollment process. WorkNet Current ONLY funds Natural Hair and Braiding Certifications.

Apply At worknet20.org/apply-for-wioa/

I have submitted my application with WorkNet?

SCHOLARSHIPS ARE CURRENTLY UNAVAILABLE

Schedule

School Schedule Hours

Full Time:

Monday 8 a.m. until 5 p.m.

Tuesday 8 a.m. until 5 p.m.

Wednesday 8 a.m. until 5 p.m.

Thursday 8 a.m. until 5 p.m.

Friday 8 a.m. until 5 p.m.

Saturday 8 a.m. until 5 p.m

Part Time:

Wednesday 5:30 p.m. until 9:30 p.m.

Thursday 5:30 p.m. until 9:30 p.m.

Saturday 8 a.m. until 5 p.m.

Closed

Sunday

Select your preferred class schedule.

Part-time (16+ hours)

Full-time (32+ hours)

Getting to know you!

What is your primary reason why you are interested in this career?

What experience do you have in these industry?

List any limitations you may have that will affect your ability to succeed in this program.

How will you support yourself financially while in school?

Do you expect work and school to have a conflict?

If you have a child or children have you made stable childcare arrangements?

Do you have reliable transportation?

Once you complete this program what are your career plans?

What do you plan to do within a month of graduation?

What questions or concerns do you have for us?

What special accommodations if any would you need from us?

A non-refundable deposit of $75 is required to confirm your enrollment.

Enrollment Fee (non-refundable)

$75.00

Pay with Card (Stripe)

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I understand that this is an application for enrollment, not a contract. All information provided is true and complete.

Signature

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