Return T0: Levittown Beauty Academy
8919 New Falls Road - Levittown, Pa. 19054
- 215 943-0298 Fax 215 943-0966
Cosmetology - Full Program
Manicuring - Nail Artistry
Cosmetology Manager
Cosmetology Teacher
Class Schedule Requested
Fulltime Days
Part Time Evenings
Combination
Classes begin the first Monday of each Month.
-
- When would you like to begin classes? Month and Year
PERSONAL DATA
Last Name First Name Middle
Social Security No. Date of Birth
Address:
Street City State & Zip Code
Telephone Number: (please include area code)
Home: Office: Email:
Previous Education
- Have you graduated from High School or hold a GED? Yes No
Date of High School Graduation (Month and Year)
GED Diploma from State:
Date Received (Month and Year)
Have you attended any school (s) after High School? - No Yes - If yes please complete the following:
School's Name and Address Dates Attended Received Aid
From: To: Yes or No
Do you now hold a professional license in any cosmetology skill? Yes No
Licensure Number and Issuing State: if applicable.
- If you have any questions or would like to provide
any further information please do so below?