Enrollment Application Step 1 of 2 50% DISCLAIMER - A one-time NON-REFUNDABLE application fee of $25.00 must be made (online) in order to submit your application. Please do not submit an application unless you have a high school diploma or GED that is recognized by the Department of Education. If you are unsure if your high school diploma or GED is acceptable please Contact Us or call 503.652.2668 before submitting your application. The application expires one (1) year from date of purchase. You must be at least seventeen (17) years of age to apply. Please fill out the following information: Name First Last Address Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAntigua and BarbudaArgentinaArmeniaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBrazilBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCosta RicaCôte d'IvoireCroatiaCubaCuraçaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEast TimorEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFaroe IslandsFijiFinlandFranceFrench PolynesiaGabonGambiaGeorgiaGermanyGhanaGreeceGreenlandGrenadaGuamGuatemalaGuineaGuinea-BissauGuyanaHaitiHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJordanKazakhstanKenyaKiribatiNorth KoreaSouth KoreaKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMauritaniaMauritiusMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew ZealandNicaraguaNigerNigeriaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaSaint Kitts and NevisSaint LuciaSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSpainSri LankaSudanSudan, SouthSurinameSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTogoTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.YemenZambiaZimbabwe Country Mobile Phone*Home PhoneWork PhoneEmail** Marital StatusChoose oneSingleMarriedSeperatedDivorcedAge***Social Security NumberEthnicityName of High SchoolDate Graduated High School City & StateAre you a U.S. Citizen?YesNoCountry of BirthAlien Registration Number (if applicable)How long have you been a resident of Portland, OR?Do you plan on taking the State Board Licensing Exam?YesNoI don't knowSelect Program of InterestChoose oneCosmetology/Full CourseHair DesignEstheticsNailsBarberingCadet InstructorSafety & SanitationCareer DevelopmentFull or Half Time StudentChoose oneFull TimeHalf Time*Providing your mobile phone number indicates your consent to receive text messages from Academy of Hair Design. Depending on the terms of your mobile plan, you may incur a charge for received text messages. **Providing your email address indicates your consent to receive email information from Academy of Hair Design. ***Applicants must be at least 17 years of age to apply. $25.00 application fee is NON-REFUNDABLE.AcknowledgmentI have read the above Disclaimer and understand that the $25.00 application fee is NON-REFUNDABLE. I also understand that by submitting an enrollment application, I am not yet considered an accepted student of Academy of Hair Design. Application Fee Price: $25.00 Total $0.00