Name

First Name

Last Name

Pronouns

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Tell us about you! We want to know your dreams, what brings you joy and how you see a career in the cosmetology world inspires you.

Have you graduated from High School or obtained a GED?

What is your highest level of education

Birth Date

YYYY

Preferred Start Date for the Cosmetology Program

Are you interested in Part Time (day/night) or Full Time?

Thank you so much for your interest in Hideout Academy. We are dedicated to progressive, inclusive education and look forward to learning more about you!