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Post #2216
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Post #2216
PROGRAM ENROLLMENT
Please select your open enrollment date
July 25, 2022
Sept 12, 2022
October 31, 2022
GENERAL INFORMATION
First Name
Last Name
Date of Birth
Drivers License #
State Issued In
Mailing Address
City
State
Zipcode
Home Phone #
Cell Phone #
Email Address
Cell Phone Carrier
Employer
EMERGENCY CONTACT
Name
Phone #
Relationship
Name
Phone #
Relationship
EDUCATIONAL BACKGROUND
A High School Diploma or GED equivalent is a prerequisite to enrollment in a Makana Esthetics Wellness Academy (a.k.a. Makana Academy)
programs, unless otherwise specified in the program outline. Please submit a copy of either of these documents upon enrollment.
Did you graduate from high school?
Yes
No
If no, do you have a GED equivalent?
Yes
No
Name of High School & Year of Graduation
City, State
Have you attended a Post-Secondary School?
Yes
No
Name of School & Year of Graduation
City, State
Any special emphasis courses?
What level of education have you completed? (Check all that apply)
High School Diploma (or GED equivalent)
Undergraduate Degree
Graduate Degree
Other
Do you have any education/experience related to Esthetics?
Yes
No
If yes, please explain:
Have you studied any anatomy, physiology or biology?
Yes
No
If yes, how advanced were your studies?
ESTHETICS INTEREST
How did you hear about Makana Academy? (Check all that apply)
Print Ad
Friend
Online
Career Fair
Social Media
Other
How did you decide you wanted to become an Esthetician?
Have you ever had a manicure, pedicure, facial or spa treatment?
Yes
No
What area of Esthetics are you most interested in?
Make-up
Skin care
Hair removal
Facials
Not sure
FINANCIAL RESPONSIBILITY
How do you intend to pay for your education at Makana Academy? (Please check one)
I will be paying for the program with my own finances
I will be paying for the program with the finances of another individual* or a financial institution
Other
*If another individual (parent, guardian or other) will be financially responsible for your tuition, please provide the following information:
Name of Guarantor
Phone Number of Guarantor
Address of Guarantor
City
State
Zipcode
DOCUMENTATION
The following documents are required to be submitted or the application will be considered incomplete. Prospective students may submit the completed application first, and then submit the required documents separately. Please bring your required documents with you at your tour appointment.
Documentation Requirement
High School Diploma or GED Equivalent
Social Security Card
PLUS, any two (2) of the following:
Birth Certificate
Drivers License
State Issued Photo ID
U.S. Passport
To the best of my knowledge, this application has been completed with true and accurate information. I understand that supplying false information on any portion of this application may result in the rejection of this application or may result in expulsion from Makana Academy if this information is found false at any time during my enrollment. Before submitting your application, please review it to ensure that each section has been completed accurately and in its entirety. If a question or section of this application does not apply to you, please mark it with N/A. Do not leave any sections blank. All requested documentation is required to be submitted during the enrollment process.
Agree
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