Please enable JavaScript in your browser to complete this form.Please enable JavaScript in your browser to complete this form.Enrollment ApplicationHow to Apply: 1. Complete this application form and return it along with a copy of your driver's license, SSI, and high school diploma. (Don't know if you need a birth certificate?) 2. Sign application form and submit registration fee. Please enter ALL required fields * with valid data.Name *FirstLastAddress Line 1 *Address Line 2City *State *Zip Code *Daytime Phone Number *Email *Date of Birth *Student Social Security Number *Gender *Course ProgramAestheticianBarberingCosmetologyBarber/Cosmo CrossoverCosmo/Barber CrossoverEntrepreneurshipHair WeavingInstructors CertificationRefresherEnrollment Date (mm/dd/yyyy) *Have you graduated from high school or obtained a GED? *YesNoName of school: City, State, and Date Attended ot GraduatedHave you been convicted of a felony?YesNoIf yes, Probation-------Parole----------Deferred Judaification-------? Write them belowFill in your answers and you'll receive a Criminal Conviction Application to be filled out by you.How did you hear about Golden Touch Academy?FriendGoogleWalk-InOtherIn case of emergency notify: Name *FirstLastRelationship *Address *Cell Phone Number *Medical information that you would like the school to be aware of. Please list below: *T-Shirt SizeSmock SizeColorPrevious Transcript Hours?YesNoAre you right or left handed?RightLeftStart DateFinish DateUpon completion of the enrollment application, state that you agree by checking the statements below...I understand that I must wear a mask during my services to help with the transmission of COVID-19I agree to obey all the rules and regulations set by GTA and CDC during my time in rolled in the course of choice, to help minimize the transmission of COVID-19.I agree and or can provide proof that I have tested negative for COVID-19 in the last 14 days.Do you have any of the symptoms? Click on all that apply.CoughShortness of BreathHigh FeverMuscle painBody achesNauseaLost of taste or smellIn the last 14 days have you come in contact with anyone that has COVID-19 symptoms?YesNoAre you living with someone that has been diagnosed with COVID-19 in the last 14 days?YesNoI agree not to visit the school or Salon to receive any services if I have symptoms of COVID-19. I acknowledge that the information that I have given in this consent form is accurate and complete. By signing below I also confirm and I agree to all terms on this form.Sign your name and today's date hereParent/Guardian SignatureParent/Guardian sign hereI certify that all statements made on this application are complete and trueYesNoSubmit
