Visitor Intake - New York - Christine Valmy

Contact Information

First Name*

Last Name*

Email Address*

Date of Birth*

Gender Identity*

Cell Phone*

Home Phone

Work Phone

Texting
Click here to accept to be reached by text.

Street Address*

City*

State*

Zip Code*

Enrollment Officer*

Language
Is English Your Native Language?

Native Language (if other than English):

Emergency Contact

Name

Phone

Relationship

Introduction

Who, if anyone, have you already spoken to at our school?

How did you hear about Christine Valmy International School for Esthetics, Skin Care & Makeup?

Employment

What is your current occupation?

What are your working hours?

What are your expectations with this degree?

Schedule

What is your preferred schedule?
DayNightWeekends

Citizenship

Please check what describes yourself:*
You are a United States citizenYou have a Green CardOther: Please Explain Below

Other Citizen Explanation

Courses of Interest

Education

High School

Name of High School attended (or "GED")

City

State/Province

Graduation Year*

College

Name of College or Other School(s) attended

City

State/Province

Graduation Year

Have you ever previously attended a post-secondary school (even if you did not graduate)?
Yes

Financial Aid

Are you interested in applying for financial aid?
Yes

Have you ever applied for or received financial aid?
Yes

Event

Attended Open House
Yes

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