First Name *

Last Name

Email *

Phone

Current Address

Previous Address

If less than 2 years at above address?

City

State/Prov/Region

Postal/Zip

Country

Are you a U.S. Citizen?

If no, are you authorized to work in the U.S.?

Social Security Number

D.O.B.

Do you have a disability?

If yes, Blueprint has partnered up with a company that can sponsor your tuition.

Employment History

Place of Employment

Name of Employer

Dates of Employment

References

Reference 1

Phone Number

Education

You are not required a high school diploma to be accepted into the program. As long as you have completed the 10th grade.

Do you have a high school diploma?

Graduation Date

High School Name

High School Location

If no high school diploma, do you have a G.E.D.? *

What is the highest COMPLETED level of your education? *

Program Information

Program of Interest

Have you previously received training in any of these fields? *

If Yes, which field?

Are you currently enrolled in a nails, barbering, cosmetology, natural hair, or esthetics program?

If Yes, which one(s)?

Referral Information

Please indicate how you were referred to Blueprint Hair Academy:

Name of person / publication:

Do you intend on going to State Board to become state licensed? *

Do you intend to work in the field utilizing the education that you will receive at Blueprint Hair Academy? *

NACCAS, Bureau for Private Postsecondary Education and the Board of Barbering and Cosmetology require us to track your employment following graduation; do you have any issue with the administration staff staying in contact with you, and requesting this information following graduation? *

I agree Terms and Conditions

By submitting this form, I agree that Blueprint Hair Academy may call, text and/or email me about their educational services. I also understand that prices are subject to change at any time without notice. The new prices will be applied to the new enrollments only. After completing this registration form, please pay registration fee. Two weeks prior to enrollment, enrollment deposit is due.

Blueprint Hair Academy does not discriminate in its employment, admission, instruction, or graduation policies on the basis of sex, religion, sexual orientation, gender identification, age, ethnicity, disability, race, creed, financial status, area of origin, or residence. If you need financial assistance and would like to apply for a loan, please click the link below:

http://bphacademy.joinlumion.com/apply

Blueprint Hair Academy Registration Form

Employment History

References

Education

Program Information

Referral Information

Acrylic Nail