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2012 STARTING AND ENDING DATES

PLEASE CHECK THE APPROPRIATE BOXES

DAYS       EVENINGS       SATURDAYS

BASIC CAREER COURSE 100 HOURS
       DATES YOU WISH TO ATTEND 		ADVANCED CAREER COURSE 300 HOURS
       DATES YOU WISH TO ATTEND




DEC 19, 2011 - JAN 13, 2011
JAN 23, 2012 - FEB 17, 2012
FEB 27, 2012 - MAR 23, 2012
APR 2, 2012 - APR 27, 2012
MAY 7, 2012 - JUNE 1, 2012
JUNE 11, 2012 - JULY 6, 2012
JULY 16, 2012 - AUG 10, 2012
AUG 20, 2012 - SEPT 14, 2012
SEPT 24, 2012 - OCT 19, 2012
OCT 29, 2012 - NOV 23, 2012
DEC 3, 2012 - DEC 28, 2012
DEC 19, 2011 - FEB 24, 2012
JAN 23, 2012 - MAR 30, 2012
FEB 27, 2012 - MAY 4, 2012
APR 2, 2012 - JUNE 8, 2012
MAY 7, 2012 - JULY 13, 2012
JUNE 11, 2012 - AUG 27, 2012
JULY 16, 2012 - SEPT 21, 2012
AUG 20, 2012 - OCT 26, 2012
SEPT 24, 2012 - NOV 30, 2012
OCT 29, 2012 - JAN 4, 2013
DEC 3, 2012 - FEB 10, 2013



2011 School Holidays
Memorial Day (5/26-5/28) Independence Day (7/4) Labor Day (9/1-9/3)
Thanksgiving (11/22-11/25) Christmas (12/24-12/25) New Year's (12/31-1/1)
*Please note that holidays are not included in the Basic/Advanced Hours.
This will extend certain ending dates.*



GENERAL INFORMATION
FULL NAME MR. MRS. MS.
MAIDEN NAME
OTHER NAMES USED
HOME ADDRESS
CITY // STATE // ZIP // COUNTRY
SOCIAL SECURITY NUMBER
DATE OF BIRTH
AREA CODE + PHONE - HOME
AREA CODE + PHONE - OTHER
E-MAIL
HOW DID YOU HEAR ABOUT US?
HAVE YOU HAD ANY PREVIOUS GROOMING EXPERIENCE? YES NO
IF YES, WHERE AND WHEN?

BACKGROUND INFORMATION
NAME OF LAST HIGH SCHOOL
ADDRESS OF HIGH SCHOOL
DID YOU GRADUATE? YES NO
IF YES, YEAR?
IF NO, DO YOU HAVE A GED? YES NO
DID YOU ATTEND SCHOOL AFTER HIGH SCHOOL? YES NO
IF YES, NAME THE POST-SECONDARY SCHOOL
NAME OF CURRENT EMPLOYER
ADDRESS
CITY // STATE // ZIP // COUNTRY
 AREA CODE + PHONE NUMBER
SPOUSE'S NAME
AREA CODE + PHONE NUMBER
SPOUSE'S EMPLOYER
PARENT'S NAME
PARENT'S PHONE
ADDRESS // CITY // STATE // ZIP // COUNTRY
PERSONAL REFERENCE
RELATIONSHIP
ADDRESS
AREA CODE + PHONE

MEDICAL HISTORY
ALLERGIES YES NO      IF YES, WHICH?
DIABETES YES NO
HEART CONDITION YES NO
IMPAIRED VISION YES NO
PROSTHETIC DEVICES YES NO      IF YES, WHICH?
ARE YOU ON MEDICATION? YES NO      IF YES, WHICH?


SIGNATURE_______________________________DATE___________________



Please contact us if you have any difficulty in meeting our schedules.

IMPORTANT: You must complete ALL questions on this enrollment application.
Print this application and mail it to us with a non-refundable fee of $50.00.*
*Fee must accompany this application.