First Name	Middle Initial		Last Name
Address
City	State		Zip
Phone (814-555-1234)		Email
Social Security Number (123-45-6789)		Date of Birth (04/06/1980)
Marital Status: Single Married Separated Divorced Widowed		Education: High School Diploma GED Neither
I will be going to school: Full Time Part Time		I am applying for: Operator's (1250 Hours) Teacher's (500 Hours) Manager's (300 Hours) Nail Technician (200 Hours)
Class date you are enrolling for:		Do you have previous hours in cosmetology? Yes No
Are you a U.S. Citizen? Yes No		Are you a veteran of the Armed Forces? Yes No
Do you have dependant children? Yes No		Will you live with your parents while attending Pruonto's? Yes No
Other than high school, have you ever attended any colleges or trade schools? Yes No (Do not include Vo-Tech unless you paid for your education)
If yes, please list:
Have you ever received grants or borrowed student loans? Yes No
Are you in default of any student loans? Yes No
Driver's License Number: State: