Application For Admission – Winchester Memphis, TN


Please fill out the application below.

What location are you interested in attending? Memphis, TN - Jackson AveMemphis, TN - WinchesterJackson, 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 AmericanCaucasianHispanicOther

Sex: MaleFemale

Marital Statue: MarriedSingleDivorcedWidowed

# of Dependents:

Gross Income:
WeeklyMonthlyBi-WeeklyYearly
$

Are you a US citizen? YesNo

If no, country of citizenship:

Are you a permanent resident if the US? YesNo

Alien Registration #:

EDUCATION

Are you presently in High School? YesNo

Are you under 18 years of age? YesNo

Do you have a: DiplomaGED

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: YesNo

Year Attended:


Name of College or School:

City/State:

Date Attended:

Start:

End:

Degree: YesNo

Year Attended:


Attach additional information on a separate sheet if needed



EMPLOYMENT

Employer Name:

Employer Phone:

Date Employed:

Start:

End:

Schedule: DayAfternoonNightFull TimePart TimeSeasonal

From o'clock, To o'clock

MTWTHFRSATSUN

BARBER COURSE

Entering Month/Year:

Right HandLeft Hand

CHOOSE Full Time / Part Time:

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

CHOOSE ALL THAT APPLY:

The Barber School Scholarship ProgramFinancial Aide ServicesVeterans (V.A.)

RE-ENROLLED:

Hours Credited:

Hours Needed:

TRANSFER STUDENT:

Hours Credited:

Proof of hours, if any from State Board YesNo

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:

or print out this pdf.

ADMISSIONS APPLICATION


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