Student Application

*Name:
*Address:
*City:
*State:
*Zip:
*Phone:	()
Cell:	( )
*Place of Employment:	How Long?
*Employer Phone:	( )
*Emergency Contact:	Relation:
*Emergency Phone:	( )
*Social Security Number:
*Driver's License Number:
Are you at least 21 years of age? Yes No
Do you have a GED or High School Diploma? Yes No
What is your highest level of education?
What certificates or licenses do you hold?
Have you ever been convicted of a felony? Yes No
By subiitting this form, I warrant that I have answered all questions to the best of my ability and knowledge. In addition to submitting this form, please mail a copy of your resume, official GED or highschool transcripts. and college transcripts. Mail these items to: Artistic School of Permanent Makeup 5712 S. Western Oklahoma City. OK 73109