Please enable JavaScript in your browser to complete this form.Please enable JavaScript in your browser to complete this form.Name *FirstMiddleLastDate *SexMaleFemaleAddress *Address Line 1City--- Select state ---AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodePhone Number *Primary E-mail Address *Driver’s License # or State ID # *State of ID *Marital StatusSingleMarriedSeparatedDivorcedWidowedU. S. CitizenYesNoBirthplace (City, State/Country) *Employer NamePhoneAddressAddress Line 1City--- Select state ---AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodePlease select last grade completed9101112GED School NameGraduatedYesNoGED School NameGraduatedYesNoCollege NameCourse/s StudiedGraduatedYesNo of training select Disclaimer The prospective student must contact the State Board to determine whether they are eligible to apply for a state license. Have you ever been convicted of a felony or currently awaiting trial on felony charges? *--- Select Choice ---YesNoAre you on probation or parole?YesNoIf yes, explain in detail including name and telephone number of probation officerReferences of persons who are likely to know your address in the future NameAddressAddress Line 1City--- Select state ---AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodePhoneNameAddressAddress Line 1City--- Select state ---AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodePhoneEmergency Contact NamePhoneRelationshipDo you have any medical condition or impairment which might affect your training at La Dolce Vita Cosmetology Institute?YesNoIf yes, explainHow did you learn about La Dolce Vita Cosmetology Institute?Who (other than you) most influenced you in your final decision to enroll at La Dolce Vita Cosmetology Institute?Course Applying For *--- Select Choice ---CosmetologyCosmetology InstructorI wish to apply for admission for the month of __ May 4, 2026MM123456789101112DD12345678910111213141516171819202122232425262728293031YYYY202720262025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Transfer Students: Previous training at School Name, address, phone#, and total hours completedThe following information must be filled out if applicant is a minor Parent/s-Guardian/s Full NameAddressAddress Line 1City--- Select state ---AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodePhoneEssayAt the time of Registration: You must present a copy of your Birth Certificate or Driver’s License along with a copy of your High School Diploma or GED. If you graduated from a high school or obtained a GED certificate but are unable to provide the actual documentation you must provide an official transcript. All diplomas from countries outside the USA must be evaluated by an approved Foreign Credential Evaluator before enrollment. Online diplomas are unacceptable unless they can provide documentation for National Accreditation. Application and Registration Payment Policy Application Fee is $75.00 A deposit is required at the time of registration. The deposit for the Cosmetology course is $5,500.00. The deposit for the Instructor’s course is $1,500.00. Applicant Signature Clear Signature DateParent/Guardian Signature (if applicant is a minor) Clear Signature Date Electronic Signature Authorization *By submitting this Application for Admission, I acknowledge and agree that my electronic signature, including a typed name or any other form of electronic authentication, is the legally binding equivalent of my handwritten signature. I certify that all information provided in this application is true, complete, and accurate to the best of my knowledge. I understand that any false or misleading information may result in denial of admission or dismissal if admitted. I further consent to the use of electronic records and signatures in connection with this application and any related documents.Submit Application