Esthetics Program Application Form

Have you been in touch with a Blanche Macdonald Director? Yes No
If yes, please let us know who so we can process your application faster:

Personal Information

First Name
 Last Name
  
Date of Birth
 Social Insurance Number (optional)
Mailing Address
 Street
 City
Province/State
 Postal/Zip Code
 Country
Telephone
 Fax
 Mobile/Pager
Email
 Occupation
 Employer
When is the best time to contact you?

Please list three contacts in the event of an emergency:

Name
 Telephone

 Address
 Email Address
Name
 Telephone

 Address
 Email Address
Name
 Telephone

 Address
 Email Address

Please select one of the following:

I am applying as a:
Canadian citizen
Landed immigrant
Foreign student (TOEFL or TOEC scores must be forwarded to the school or an internal English proficiency test will be administered)

Program Interest

I would like to apply for the following program (please check your choice):

  Esthetics Day Program
Esthetics Evening Program
Starting On
  Other: please specify

Financial Responsibility

Have you ever had any types of loans? (school, personal): Yes No
If yes, please specify

Have you ever defaulted on a loan? Yes No
If yes, please specify the type of loan default

Students who qualify for BC and Canada Student Loans must have completed Grade 12 or be 19 years of age.

Please check the appropriate choice below:

I would like to apply for a BC/Canada Student Loan
I am obtaining a loan through other means (please specify: )
I am paying for the course through my own finances
Other (please specify: )

In addition:

My high school or college transcripts are enclosed
My transcripts will be forwarded by

Upon receipt of completed application and acceptance into the college, students must provide the appropriate enrollment fee (or advanced payment in full). An official enrollment agreement will be issued and your name added to the list for the program/course of your choice.

Educational Information

Did you graduate from high school? Yes No

Did you attend a Post Secondary Institution? Yes No
If yes, please tell us where:

What level of education? (please specify area of study and name of institution)

High School
Diploma, please specify
Undergraduate Degree, please specify
Graduate Degree, please specify
Other, please specify

Do you have any education or experience that may relate to the study of Esthetics? Yes No
If yes, please specify:

Have you studied anatomy or physiology? Yes No
If yes, how advanced were your studies?

Health

Do you have any health issues/problems that the school should be aware of? Yes No
If yes, please specify

Are you taking any medications that the school should be aware of? Yes No

Do you have normal hand/eye coordination? Yes No

Do you have any allergies or skin sensitivities that would prevent you from receiving Esthetic treatments (is. psoriasis, excema)? Yes No
If yes, please specify

General Interest

Have you applied make-up or skin care to others? Yes No

Have you ever experienced a spa treatment (ie. facial, manucure, massage)? Yes No

Are you comfortable receiving Esthetics services from others? Yes No

How did you decide that you wanted to be an Esthetician?

What area of Esthetics appeals to you the most?
Promotion of health
Involvement with the medical field
Nurturing/caring dynamics
Business development potential
Other, please specify

How did you hear about Blance Macdonald Centre?
Reputation
Advertising, please specify
Internet, please specify
Blanche Macdonald's Page on Facebook
Magazines/Newspapers, please specify
Referral, please specify
Other, please specify

Why did you choose Blanche Macdonald?

This application has been completed by:

Name of Applicant

Name of parent or guardian (if applicant is under 19)