STUDENT APPLICATION First Name Last Name Birthday Email Mailing Address Phone or Text Number How Did You Hear About Us? Internet Friend Drive By Current Professional If friend or current professional please leave their name so we can know who to thank! High School or GED School Name High School City, State Dates attended Diploma G.E.D. How do you intend to pay for school? Job Spouce Parents Other How would our team be better by having you on it? Personal Reference #1 References phone number Reference relationship to you Personal Reference #2 References phone number Reference relationship to you Personal Reference #3 References phone number Reference relationship to you Please read and check that you accept the following I understand that this application must be completely filled out in order to be considered for enrollment at Cosmoton Academy. I understand that the application fee of $250 payable to Cosmoton Academy must be made at the time of enrollment and the application fee is NOT refundable unless you are not accepted. This application does not guarantee acceptance to Cosmoton Academy. I understand the location of Cosmoton Acadmey is 1013 North "H" Street in Lompoc, California. I am aware that I must provide proof of high school graduation or proof of GED completion in order to attend Cosmoton Academy. In addition, I must provide a copy of my driver's license, birth certificate or state issued ID and Social Security number. I have a strong desire to learn. I realize that in order to obtain my Barber license it will take hard work and discipline on my part in order to graduate and have the skills that will allow me to be successful. I agree to dedicate myself to the training provided while attending Cosmoton Academy. Upon acceptance at Cosmoton Academy, I agree to conduct myself in a professional manor at all times. I agree to corporate with staff members and instructors and to follow instructions and policies of the school. I am signing that the information in this application is true and accurate. I understand all the areas that I have initialed. Upon completion of this step I will be required to have a phone interview as further evaluation of my application. I agree to be contacted by a Cosmoton Academy admissions team member. Message and data rates may apply. I agree to allow Cosmoton Academy to store my data.