Admission


STUDENT INFORMATION

What location are you interested in attending?  Memphis, TN - Jackson Ave Memphis, TN - Winchester Jackson, TN

Title:  Mr. Mrs. Miss

Name Last: (required)

First Name: (required)

Middle Name:

Cell Phone: (required)

Home Phone:

Address: (required)

City/State: (required)

Country: (required)

Zip: (required)

E-Mail Address: (required)

Social Security #: (required)

Date of Birth: (required)

Place of Birth
City/State: (required)

Country: (required)

Ethnicity:  African American Caucasian Hispanic Other

Sex:  Male Female

Marital Statue:  Married Single Divorced Widowed

# of Dependents:

Gross Income:
 Weekly Monthly Bi-Weekly Yearly
$

Are you a US citizen?  Yes No

If no, country of citizenship:

Are you a permanent resident if the US?  Yes No

Alien Registration #:

EDUCATION

Are you presently in High School?  Yes No

Are you under 18 years of age?  Yes No

Do you have a:  Diploma GED

What year did you receive diploma or GED?

What school did you graduate or receive you GED from?
Name:

Address:

City/State:

Country:

Zip:

Phone:

LIST BELOW ALL COLLEGES OR POST - SECONDARY SCHOOLS ATTENDED:

Name of College or School:

City/State:

Date Attended:

Start:

End:

Degree:  Yes No

Year Attended:


Name of College or School:

City/State:

Date Attended:

Start:

End:

Degree:  Yes No

Year Attended:


Attach additional information on a separate sheet if needed



EMPLOYMENT

Employer Name:

Employer Phone:

Date Employed:

Start:

End:

Schedule:  Day Afternoon Night Full Time Part Time Seasonal

From o'clock, To o'clock

 M T W TH FR SAT SUN

BARBER COURSE

Entering Month/Year:

 Right Hand Left Hand

CHOOSE Full Time / Part Time:

 FT: M-Th 9am-6pm PT Day: M-Th 9am-1pm PT Day: M-Th 2pm-6pm

CHOOSE ALL THAT APPLY:

 The Barber School Scholarship Program Financial Aide Services Veterans (V.A.)

RE-ENROLLED:

Hours Credited:

Hours Needed:

TRANSFER STUDENT:

Hours Credited:

Proof of hours, if any from State Board  Yes No

PREVIOUS SCHOOLS:

Name of School:

City/State/Zip:

Phone:

IN CASE OF EMERGENCY ONLY
(Must have at least two family members reference information)

EMERGENCY CONTACT 1

Name:

Address:

Phone:

Relationship:

EMERGENCY CONTACT 2

Name:

Address:

Phone:

Relationship:

I certify that all of the is correct to the best of my knowledge. If accepted as a student at The Barber School, I agree that during such time as I may be enrolled as a student, I will abide buy by all the rules, regulations, and practices of The Barber School as they may be at the time of admission or as they may be changed during my continuance as a student. The Barber School Adheres to the principle of equal education opportunity without regard to race, handicap, sex, color, creed, or national origin. This Policy extends to all programs and activities involving or supported by this school.

Student Agreement:

 Check here to agree with the above statement(required)

Print Name: (required)

Date: (required)

Parent Agreement:

 Check here to agree with the above statement

Print Name:

Date:

 

Click on the link mclear@thebarberschool.edu


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