APPOINTMENT
Please select your preferred appointment date:
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Please select your preferred appointment time:
Please Choose
9:00AM
9:30AM
10:00AM
10:30AM
11:00AM
11:30AM
12:00PM
12:30PM
1:00PM
1:30PM
2:00PM
2:30PM
3:00PM
3:30PM
4:00PM
4:30PM
5:00PM
5:30PM
6:00PM
6:30PM
7:00PM
7:30PM
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Please indicate the CAPRI Campus you prefer:
Clifton
Kenilworth
Paramus
Brick
Roxbury
Please Choose
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What is the best time to contact you?
7:00 - 9:00 AM
9:00 - 11:00 AM
11:00 - 1:00 PM
1:00 - 3:00 PM
3:00 - 5:00 PM
5:00 - 7:00 PM
7:00 - 9:00 PM
9:00 - 11:00 PM
Please Choose
*
CAPRI can contact me by:
Text
E-mail
Skype
Phone
Text or E-mail
Text or Skype/Phone
E-mail or Skype/Phone
Any type is OK
Do not contact
Please Choose
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GENERAL INFORMATION
First Name:
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Last Name:
*
Gender:
MALE
FEMALE
Please Choose
Email:
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Address1:
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Address2:
City:
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State:
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ZIP Code:
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Country:
Skype Name:
Cell or Alternate Number:
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Country Code if applicable
Cell Phone Service Provider:
Please Choose
AT&T
T-Mobile
Sprint
Verizon
Cingular
Nextel
Virgin Mobile
Helio
Boost Mobile
Tracfone
Qwest
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Work Telephone Number:
Country Code if applicable
Which Program Are You Interested In?
Cosmetology
Cosmetología En Español - Recinto de Clifton Solamente
Skin Care
Nail Technology
Instructor Training
Please Choose
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When Would You Like To Start Your Classes?
JAN
FEB
MAR
APR
MAY
JUN
JUL
AUG
SEP
OCT
NOV
DEC
Please Choose
2009
2010
2011
Please Choose
Which Schedule Are You Interested In?
Days
Nights
Mom or Dad's Day Program (1/2 Hr. Early Dismissal)
Undecided
Please Choose
EDUCATION
Do you have a high school diploma or GED?
Yes, High School Diploma
Yes, GED
No HS Diploma/No GED
Please Choose
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IF YES, Name of institution:
Name as it appears on institution academic records:
Have you applied to CAPRI before?
YES
NO
Please Choose
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If YES, for which year?
Have you attended college or a trade school
before?
YES
NO
Please Choose
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IF YES, Name of institution:
If YES, how long did you attend?
Less Than 1 Year
1-2 Years
2-3 Years
3-4 Years
More than 4 years
Please Choose
Degree Received:
None
Associate’s
Bachelor’s
Master’s
Please Choose
FINANCIAL PLANNING
Are you a U.S. Citizen?
YES
NO
Please Choose
*
If NO, are you an eligible non-citizen?
YES
NO
Please Choose
Will you be seeking financial assistance?
YES
NO
Please Choose
*
Have you ever applied for financial aid
before?
YES
NO
Please Choose
*
How did you hear about CAPRI?
CAPRI Website
BeautySchoolDirectory.com
Superpages.com
Google "Adwords" Advertising
Google Search Engine
Yahoo Search Engine
MSN Search Engine
Other Sites
Other Search Engines
TV Commercial
Cable
News
Newspaper Ad
1-800-BE-CAPRI
Yellow Pages (Printed)
Other Medias
Salon Owner
CAPRI Grad.
HS Guidance
Friend
Other People
Walk-In
Drive-By
Radio: 94.3 FM, The Point
Other
Please Choose
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Questions or Comments:
Is there someone else you know that is interested in a career in cosmetology, skin care, or nail tech?
If yes, please list name and contact information.