Post-Secondary Education APPLICATION PROCESS Cosmetology - evening program TO: Prospective Adult Students FROM: John Smith Thank you for your interest in the Waynesville Career Center. This application packet contains forms and information you will need to apply for the next class which begins September 18th, 217. It is important that you read and complete the application thoroughly. Applications are due no later than August 18th, 217. If you have any questions, please feel free to contact the Assistant Director at 573 842 25 (Ext. 2514). To complete the Application Process, please turn in the following paperwork: 1. Completed application 2. $1. non refundable application fee 3. Official High School Transcript, Official GED Transcript, or High School Diploma 4. Applications will not be processed until all application information is received 5. Background check $12, and is done online 6. All Students must complete the FAFSA online, including A+ students. www.fafsa.ed.gov School code 14833 (EMT B & CNA do not qualify for financial aid) 7. The program to which you are applying may have extra requirements needed with the application, listed on pages 2 & 3, please read carefully. 8. Once accepted into the program student must schedule an appointment with the Financial Aid office 9. Copy of Driver s License (Cosmetology must have copy of birth certificate also) 1. Scheduling of any pre entrance testing 11. 3 References 12. NOT ALL COSTS ARE COVERED BY FINANCIAL AID IMPORTANT NOTICE Applications will not be processed until all application information is received. Send information to: Waynesville Career Center Post-Secondary Education 4 G.W. Lane Waynesville, MO 65583 NOTICE OF NON-DISCRIMINATION The Waynesville R-VI School District does not discriminate on the basis of race, color, national origin, sex, age, religion, disability or status as a Vietnam-era Veteran in admission/access to, or treatment/employment in its programs and activities. Any persons having inquiries concerning compliance with the regulations implementing federal legislative requirements is directed to contact the building level principal or the assistant superintendent for personnel services, (573) 842-297 (Title IX, Title VI, and ADA), or the administrative assistant for special services, (573) 842-27 (Section 54). 1
Cosmetology: Deadline for completed applications is August 18th, 217. Tuition is $6, Supplies $8 Background Check $12 Other $25 NOT ALL COSTS ARE COVERED BY FINANCIAL AID 1. Complete student enrollment form for State Board of Cosmetology 2. Turn in a $25 money order, made payable to: Missouri Board of Cosmetology, for student license (you cannot begin class without your student license) 3. Must turn in 2 photographs measuring approximately 2 x 2 4. Background check done at www.machs.gov Directions: Once you are on the site, click on Access the MACHS Name Search Portal to conduct a background check by Name, D.O.B or SSN, then click on New to Site, Click Here to get started, Click yes to continue then fill in the information and click submit. Follow the instructions to pay and to print out the background check to turn in. Cosmetology Instructor: Deadline for completed applications is August 18th, 217. Tuition is $2,9 Background Check $12 Other Costs $25 NOT ALL COSTS ARE COVERED BY FINANCIAL AID 1. Complete Cosmetology Instructor Training Enrollment Form for State Board of Cosmetology 2. Turn in a $25. money order, made payable to: Missouri Board of Cosmetology, for Instructor Training License (You cannot begin classes without your license) 3. Must turn in 2 photographs measuring approximately 2 x 2 4. Background check done at www.machs. mo.gov Directions: Once you are on the site, click on Access the MACHS Name Search Portal to conduct a background check by Name, D.O.B or SSN, then click on New to Site, Click Here to get started, Click yes to continue then fill in the information and click submit. Follow the instructions to pay and to print out the background check to turn in. 5. Must hold a Missouri License to practice as a cosmetologist, esthetician or manicurist Nail Technician: Deadline for application is August 18th, 217. Tuition is $3,185 Background check $12 Supplies $25 NOT ALL COSTS ARE COVERED BY FINANCIAL AID 1. Background check done at www.machs.mo.gov Directions: Once you are on the site, click on Access the MACHS Name Search Portal to conduct a background check by Name, D.O.B or SSN, then click on New to Site, Click Here to get started, Click yes to continue then fill in the information and click submit. Follow the instructions to pay and to print out the background check to turn in. 2. $25 money order made payable to State Board of Cosmetology 3. Board of nail technician student enrollment form 3
Waynesville Career Center 4 GW Lane Waynesville MO 655583 Telephone: 573 842 25 Adult Application for Admission A non refundable application fee (if applicable) must be submitted with this application. Please print legibly in ink. Please complete all 3 pages of this form. Date: Legal Name: Last First MI Suffix or Maiden Home Phone: Cell/Other Phone: Mailing Address: Street Address City State Zip Code Email Address: Are you a permanent resident of Missouri? Yes No Citizenship Status? U.S. Citizen/National Resident Alien Non resident Alien/ Foreign Student Have you ever been convicted of a felony or dismissed/suspended from another school for disciplinary reasons? Yes No If yes, please attach a separate sheet with a detailed explanation of the incident and probation/parole status. Answers to the next two questions are voluntary and are requested so that we can comply with federal regulations. 1. Ethnicity: Are you Hispanic/Latino? Yes No 2. Race: Are you from one or more of these five racial groups? Mark all that apply. American Indian or Alaska Native Asian Black or African American Native Hawaiian or other Pacific Islander White/Caucasian Date of Birth: Veteran: Yes No High School Diploma GED ( or other approved exam) Please mark the program you wish to apply for: Social Security Number: Gender: Male Female Year of Graduation: Year of Examination: State Graduated: Examination State: Auto Collision Technology Construction Technology EMT Masonry Automotive Service Technology Cosmetology (Day or Graphic Design TV Journalism evening) Computer Information Technology Heating, Ventilation & Air Conditioning Cosmetology Instructor Computer Maintenance Nail Technician Culinary Arts Commercial Printing Welding & Manufacturing CNA 4
How did you hear about our school? Please specify: Are you participating in or have you completed the A+ program at your high school? Yes No Have you ever been in a similar program at another school? Yes No If so, give the name of the school, date of entry, location, reason for and date of termination of your enrollment. Emergency Contact Information Contact Person: Relationship: Address: Phone: Former Employers and Work Experience Date From Date to Position Title Employer and Address Reason for Leaving Educational Background Date From Date to Name of School City & State Diploma Received and Date Character References (Must list 3) Do not include family members Name Length Known Address Zip Phone # If you have a disability which requires accommodation, please contact the Waynesville Career Center at 573 842 25 for information about services that may be available for you. To the best of my knowledge and belief, the information given in this application is complete and accurate. Failure to disclose fully and accurately all facts relating to this application shall be grounds for suspension or expulsion with loss of fees. If admitted, I pledge myself to comply in good faith, with all the rules and regulations of Waynesville Career Center as contained in the Adult Education Handbook. Signature of Applicant: Date: Admissions Procedure: Completed, signed, and dated application form Non refundable application fee. Financial arrangement must be made prior to program start date. For more information, please contact Tara Johnson at 573 842 25 ext. 2513 Copies of Driver s License, Social Security Card and High School Diploma, transcript or GED will be required. 5
TRANSCRIPT REQUEST FORM School Official: I have applied for admission to Waynesville Career Center. I was enrolled in your institution during the period. I was enrolled in the program. Please mail an official transcript of my record showing grades earned and/or graduation date to: Waynesville Career Center Adult Education Secretary 4 G.W. Lane Waynesville, MO 65583 The following information is included to assist you in sending a complete and accurate transcript. Name of Student (Please Print) Name at time of Graduation Social Security Number Date of Birth Address City State Zip Signature of Student Date of Last Enrollment Transcript Fee Enclosed 6
WAYNESVILLE CAREER CENTER Financial Aid All students must complete a FAFSA online unless other arrangements have been made by October 15, 215. The FAFSA (Free Application for Federal Student Aid) must be completed and submitted to determine eligibility for student grants, loans and scholarships that are available. You will need Waynesville Career Center s school Code: 14833. Once the FAFSA is completed online, students must schedule an appointment with Tara Johnson, Financial Aid Officer at Waynesville Career Center, 573-842-25. Waynesville Career Center participates in the following financial aid programs: Federal Pell Grant Missouri Grant Programs A+ Schools Program Workforce Investment Act (WIA) Programs Vocational Rehabilitation Programs (For those with disabilities) Veteran s Administrations Programs Institutional and Private Scholarships Tuition Assistance Direct Loans Direct Plus Loans MyCAA Financial Aid Payments For those students who have established their eligibility for the Federal Pell grant or the Missouri state grants, the funds will be disbursed directly to the student s tuition account. One half will be disbursed in first semester and one in second semester, providing the student maintains satisfactory academic progress and completes 45 clock hours of instruction per payment period. **Please see the Adult Student Financial Aid Handbook for detailed information** 8
-... '. - INSTRUCTIONS STATE OF MISSOURI DIVISION OF PROFESSIONAL REGISTRATION BOARD OF COSMETOLOGY AND BARBER EXAMINERS 365 MISSOURI BLVD., P.O. BOX 162 POST SECONDARY STUDENT ENROLLMENT APPLICATION ST JEFFERSON CITY, MO 6512 THIS FORM MUST BE USED TO ENROLL ALL STUDENTS IN SCHOOL. INCLUDING NEW, TRANSFERS, ANO THOSE SEEKING ADDITIONAL TRAINING. PLEASE PROVIDE THE ADDITIONAL INFORMATION AS REQUIRED FOR YOUR STUDENT TYPE ALONG WITH THIS COMPLETED APPLICATION (REFER TO X-ED BOXES AT RIGHT). 1. COPY OF BIRTH CERTIFICATE (PREFERRED) OR DRIVERS LICENSE FOR PROOF OF AGE. 2. PROOF OF SUCCESSFUL COMPLETION OF A TWELFTH GRADE EDUCATION (DIPLOMA OR GENERAL EDUCATIONAL DEVELOPMENT (GED) CERTIFICATE). 3. TWO PHOTOGRAPHS MEASURING APPROXIMATELY 2" X 2". 4. MEDICAL EXAM (BARBER ONLY). 5. S25. ENROLLMENT FEE. TO BE COMPLETED BY APPLICANT.. 1. LEGAL NAME (FIRST, MIDDLE, LAST) 2. SOCIAL SECURITY NUMBER ' 3. PERMANENT ADDRESS (STREET, CITY, STATE, ZIP CODE) 4. DATE OF BIRTH 5. TELEPHONE NUMBER 6. EDUCATION 7. YEAR LAST GRADE WAS COMPLETED CHECK LAST GRADE COMPLETED MO. I DAY I YEAR 8 9 1 11 12 GED ( I I ) 8. SCHOOL WHERE LAST GRADE WAS COMPLETED 9. SCHOOL ADDRESS (CITY ANO STATE) 1. CHARACTER REFERENCES - COSMETOLOGY ONLY a. NAME ADDRESS (STREET, CITY, STATE, ZIP) b. 11. 1. EVER BEEN ENROLLED IN A MISSOURI COSMETOLOGY/BARBER SCHOOL? D D HAVE 2. EVER BEEN AN APPRENTICE IN A MISSOURI COSMETOLOGY/BARBER SALON? D D YOU 3. EVER BEEN LICENSED AS A COSMETOLOGIST, HAIRDRESSER, MANICURIST, ESTHETICIAN OR BARBER IN MISSOURI OR ELSEWHERE? D D YES NO 12. THE ABOVE-NAMED APPLICANT HAS BEEN ACCEPTED FOR ENROLLMENT INTO OUR SCHOOL AND MAY BEGIN WITH OUR CLASS STARTING OR UPON RECEIPT OF THE STUDENT LICENSE, WHICHEVER IS LATER. WE HEREBY CERTIFY THAT THIS APPLICATION HAS BEEN COMPLETED TO THE BEST OF OUR KNOWLEDGE. I HEREBY MAKE APPLICATION TO ENROLL IN THE FOLLOWING SCHOOL 13. SCHOOL NAME 14. SCHOOL LICENSE NUMBER 15. SCHOOL ADDRESS 16. TELEPHONE NUMBER 17. FOR THE FOLLOWING COURSE 18. PLEASE INDICATE THE NUMBER OF HOURS ATIENDING EACH DAY CLASS CA - HAIRDRESSING AND MANICURING CROSSOVER SUNDAY CLASS CH - HAIRDRESSING BARBER MONDAY WEDNESDAY I I FRIDAY I CLASS MO - MANICURIST BARBER COSMETOLOGY TUESDAY THURSDAY I I SATURDAY CLASS E - ESTHETICIAN THE FOLLOWING QUESTIONS MUST BE ANSWERED IN ORDER TO ENROLL IN A SCHOOL, FAILURE TO DO SO WILL CAUSE THE APPLICATION TO BE REJECTED AND DELAY PROCESSING. HAVE YOU BEEN FINALLY ADJUDICATED AND FOUND GUILTY, OR ENTERED A PLEA OF GUILTY OR NOLO CONTENDERE, IN A CRIMINAL PROSECUTION IN THIS STATE, OR OF THE UNITED STATES, WHETHER OR NOT SENTENCE WAS IMPOSED? YES ONO NOTE: THIS INCLUDES SUSPENDED IMPOSITION OF SENTENCE, SUSPENDED EXECUTION OF SENTENCE, MISDEMEANOR AND FELONY CONVICTIONS, AND ALCOHOL RELATED OFFENSES, I.E. DWI AND SAC. CHECK YES IF NOT PREVIOUSLY DISCLOSED TO THIS BOARD AND PROVIDE THE DATE OF THE CONVICTION ANO/OR PLEAING, NATURE OF THE OFFENSE, COURT LOCATION, AND CASE NUMBER ON A SEPARATE SHEET. CITIZENSHIP QUESTIONS (A) ARE YOU A UNITED STATES CITIZEN OR OTHERWISE LAWFULLY PRESENT IN THE UNITED STATES? YES NO IF YOU ANSWERED "NO" TO QUESTIONS (A) ABOVE, PLEASE PROVIDE A DETAILED EXPLANATION. MO 375-966 (12-15)