Online Scholarship Application Process - Electrolysis, Electrology, Schools Program

Scholarship Application - American Institute Of Education

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If you would prefer to fill out and mail this form, download the pdf version here.

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

First Name *

Last Name *

Middle Initial

Street Address *

Sex *

E-Mail

Phone *

-

Date Of Birth *

/

(mm / dd / yyyy)

City *

State *

Zip Code *

Citizenship *

Alien No. A-

Other

Handicap that may affect your job limitations, if any:

Marital Status *

No. Dependant Children *

Are you their sole provider?

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)

High School

Diploma/Certificate/Trade

Associate

Bachelor

Masters

Ph. D.

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

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:

In a paragraph at most, tell us what attracts you to a career in Electrology.

Past Work Experience: Briefly tell us if you've ever been self-employed and what you liked most about operating your own business.

How Can We Help?
Tell us what you believe your biggest obstacle may be to becoming a Professional Electrologist.

Prove you are human:

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Phone: 888-844-4247
Fax: 714-486-1380
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Accessibility Statement

Select a Reason for Your Request:

State Licensing Requirements

Start Dates

Tuition Plans

Scholarships

Student Housing

Other

Name:

Phone Number:

E-mail Address:

State:

Contact me by:

Prove you are human:

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Scholarship Application - American Institute Of Education

This page is secured using SSL to protect your information.If you would prefer to fill out and mail this form, download the pdf version here.

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-

/

/

/

/

to

per

Family Data And Emergency Contact

-

-

-

-

-

-

/

/

Electrology Programs by State:

Looking For A New Career?

This page is secured using SSL to protect your information.
If you would prefer to fill out and mail this form, download the pdf version here.