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Barber Bootcamp Application
Please complete this form , if you are 21 years of age or under , make sure you list your parent or guardian information as well.
* Indicates required question
Email
*
Your email
First Name of Prospective Student
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Your answer
Last Name of Prospective Student
*
Your answer
Prospective Student Gender Identification
*
Male
Female
Non-Binary
Prefer Not To Say
Prospective Student Preferred Pronouns
*
He/Him/His
She/Her/Her's
They/Them/Their
Prospective Student Telephone Number
*
Your answer
Prospective Student Date of Birth
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MM
/
DD
/
YYYY
Full Name of 1 Legal Guardian (if under 18 years of age)
*
Your answer
Email Address of Legal Guardian listed above (if under 18 years of age)
*
Your answer
Telephone Number of Legal Guardian listed above (if under 18 years of age)
*
Your answer
Does the student and/or guardian receive supplemental assistance (Reduced/Free Lunch, SNAP, Medical Assistance, WIC, etc) from a government agency?
Yes
No
Clear selection
Full Name & Telephone Number of an additional Adult Emergency Contact
*
Your answer
Does the prospective student have any medical conditions we need to aware of?
*
Yes
No
Required
If you answered Yes above, please specify below. If No, type NA below.
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Your answer
Does the prospective student need responsible accommodation to assist them during training?
*
Yes
No
Required
If you answered Yes above , please specify below. If No, type NA below.
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Your answer
What form of transportation will prospective student use to & from class?
*
Public Transportation
Guardian will drop off & pick up
UBER / LYFT
Drive myself
Required
Has the prospective student been charged or convicted of any criminal activity? (this will NOT disqualify}
*
Yes
No
If you answered yes , please explain below. If answer was no , please type NA below.
*
Your answer
Please share : 1)
Describe a time in your life that has shaped who you are as a person. How do you define success? 2)
What are your goals after participating in the Barber Bootcamp program?
If you want to submit a 3 minutes or less video , please commit " video essay" below.
Your answer
The prospective student & legal guardian understands this is a 6 month commitment. Prospective student & guardian commits to fully engage in this program for success.
*
Yes , we do!
No , we aren't sure.
Required
Share any other information we may need to know about about the prospective student here.
Your answer
A copy of your responses will be emailed to the address you provided.
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