Admissions Packet
Deadline for Submission:________________
Dear Prospective Student,
The following is your check-off list to be completed before you can be accepted for enrollment into any of the
Phagans’ School of Beauty, Phagans’ Central Oregon Beauty College, Phagans’ Medford Beauty School, Phagans’ Beauty College,
Phagans’ Grants Pass College of Beauty or Phagans’ Newport Academy of Cosmetology Careers, all known hereto in as Phagans’
Cosmetology Colleges. Please make certain that you complete all forms in this packet and collect copies of all
necessary documents to submit to the college Admissions Office.
______________________________
Print your Full Name
_________________
Best Phone #
Check-off the following after completion, collection and/or submission:
 College Application for Enrollment
 Salon Visits Form
 Essay
 Personal References & Childcare Provider Commitment form
 Health & Safety Form
 Model Reference Form
 Estimated Budget Form
 College Visits:
Initial Visit(s):
Next Visit(s):
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Review General Information & School Culture
Tour the School
Review Consumer Information disclosures
Receive:
Catalog (available for download on-line)
Pre-Enrollment Self Test
HLO Licensure Requirements
Review:
FAFSA.ed.gov
Education, Age, Identity & Citizenship
required documents
Make Appt. for Next Visit
Schedule Class Visits
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Financial Planning Interview:
Budget Form &
Schedule A payment plan
Review FASFA:
www.studentaid.ed.gov
Review Self Test
Schedule Complimentary Services
Make Appt. for Next Visit
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Program Applying For
Final Visit:
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Finalize all Financial requirements
Pay Application fee of $50
Submit Completed Admission
Packet
Submit all required documentation
Submit Student Data Input Form
Sign Commitment Statement
Class Visitation Form(s): Hair __, Nail __, Esthetics __, Barbering __ (check all that apply)
Complimentary Services
Commitment Statement Form
Pay Application Fee of $50, via check, money order or credit card, this is non-refundable.
All Age, Identity, Citizenship and Education documents must be current/valid and the full names must match or be linkable
together through other official documents that may be requested:
 Proof of Education: HS Diploma, G.E.D. or A.T.B. test, and/or High School Transcript with date of graduation
 Proof of Age: Drivers License, State ID Card or Birth Certificate
 Proof of Identity: Drivers License or Passport (photo) and copy of Social Security Card
 Proof of Citizenship: Oregon Driver License/ID issued after 7/1/08 and/or US Citizenship (or eligible non-citizen) docs
Your application will be reviewed within the next 2 business days. You will receive a letter of acceptance or denial within
10 business days from the deadline for submission date above. If you have any questions please call any one of our
admission representatives. We are here to assist you. We can be reached at the following #’s:
Bend
Grants Pass
541.382.6171 ext. 2
541.479.6678
Medford 541.772.6155
Corvallis 541.753.7770
Salem 503.363.6800
Newport 541.265.3083
Revised June 2015
Application for Enrollment
Please PRINT clearly, all information must be legible. Fill out the following information completely, as it is
necessary for our files, as well as those of the state and federal agencies.
Name:
Social Security #
First
Birth Date: Month
MI.
Day
-
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Last
Year
Permanent Address
City
Phone
Email:
Place of Birth: City
State
State
Cell phone
Social Networking Page(s):
Zip
Are you a U.S. Citizen? Yes
No
If no, what is your Alien Reg. #
Are you an Oregon resident?
How long have you lived in Oregon?
Have you ever been convicted of a misdemeanor or felony?: Yes _______ No _______
(If Yes, see admissions officer regarding your ability to obtain a cosmetology license in the State of Oregon).
PARENT INFORMATION
Fathers Name
Address
Mothers Name
Address
Home Phone
Email
Home Phone
Email
SPOUSE OR GUARDIAN INFORMATION
Name
City
Home Phone
Address
State
Cell phone
Zip
IN CASE OF EMERGENCY: who should we contact on your behalf?
Name
Best Phone
WORK HISTORY:
Employer
Employer
Employer
From _____ to _____ Phone
From _____ to _____ Phone
From _____ to _____ Phone
NAME AND ADDRESS OF THREE (3) PROFESSIONAL REFERENCES:
#1. Name
Address
Home phone
Work Phone
City
State
Zip
#2. Name
Home phone
Work Phone
Address
State
Zip
#3. Name
Home phone
Work Phone
Address
State
Zip
City
City
Revised June 2015
EDUCATION:
High School Diploma*: Yes or No
If ‘Yes’: Name of High School:
* some online, most homeschool and all modified diplomas do not meet our admission requirements.
Date Received:
City, State of High School:
GED Certificate: yes or no Date taken:
Location:
Highest grade completed in High School: (Circle One) 9th 10th 11th 12th
ENROLLMENT INFORMATION:
When do you plan to enroll at Phagans' Cosmetology College?
What course(s) do you plan on enrolling in?
(check all that apply)
Hair Design
Barbering
Esthetics
Nail Technology
Cadet Teacher
POST SECONDARY EDUCATION:
Have you ever been enrolled in Cosmetology College before?
yes or no
If yes, complete information below:
College Name
Street Address
City
State
Zip
Dates attended: from
to
How many hours did you complete?
*provide a transcript
Have you ever been enrolled in Community College before? yes or no
If yes, complete information below:
College Name
Street Address
City
State
Zip
Dates attended: from
to
Did you obtain a degree? yes or no If yes, what was your major?______________________
Have you ever been enrolled in a University before? yes or no
If yes, complete information below:
College Name
Street Address
City
State
Zip
Dates attended: from
to
Did you obtain a degree? yes or no If yes, what was your major?______________________
Because we are mandated to maintain information for TITLE IV of Civil Rights Act, we are asking the following
information: answering these questions is optional at this point in the admissions process.
Age: ____ Sex: Male or Female
Race:________________________ Nationality:________________________
Marital Status: Single ____ Married ____ Divorced ____ Widowed____ Separated____
# of children: ____
Maiden Name: _____________________Previous Married Name:_______________________
Living with: Parent ____Self ____Guardian ____Spouse____ Friend ____Relative____
I give my permission for the faculty at Phagans’ to call any of the references listed throughout the admissions
packet in regards to my admission and attendance at Phagans’
Cosmetology College.
I declare that the information reported on this form to be true, accurate and complete:
SIGNATURE
DATE
Revised June 2015
Dear Salon Owner,
In order for a prospective student to be accepted for enrollment into one of our colleges, they are required
to visit a salon, spa or barber shop.
Student Applicant: please spend 30 minutes in the salon and have a list of topics for discussion. Be sure to
ask questions about working in the fields that interest you. You may also want to discuss the physical
demands of the industry and how cosmetology college prepares you for those demands.
Please fill in the appropriate information below, be certain to have the Salon Representative make their
comments as well:
#1 REQUIRED Visit Date:
Salon Owner or Representative:
Salon Name:
Address:
City:
St:
Salon Representative Comments:
Zip:
Phone:
Email:
Zip:
Phone:
Email:
Zip:
Phone:
Email:
Student Applicant Comments:
#2 OPTIONAL Visit Date:
Salon Owner or Representative:
Salon Name:
Address:
City:
St:
Salon Representative Comments:
Student Applicant Comments:
#3 OPTIONAL Visit Date:
Salon Owner or Representative:
Salon Name:
Address:
City:
St:
Salon Representative Comments:
Student Applicant Comments:
Applicant Name:
Date:
Revised June 2015
Essay Questions
Write two essays, consisting of at least 250 words each. You may use additional paper if necessary.
Please choose from the list of topics provided:
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What created the initial interest for you to consider a career in cosmetology?
What steps have you taken into investigating this industry and how long ago did you start the process?
What plan have you implemented to secure yourself financially so that you can attend college and how long
ago was this plan implemented?
What have you done to physically and mentally prepare yourself to attend cosmetology college?
Do you have good self-worth and are you able to handle constructive criticism?
What is your definition of professionalism, professional conduct?
How would you describe yourself as a person and how will that benefit you in this profession?
What are your goals and expectations once you graduate from cosmetology college?
Essay #1:
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Essay #2:
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Applicant Name:
Date:
Revised June 2015
Personal References
Reference: #1 Relationship to Applicant:
Name:
Address:
Comments:
Reference: #2 Relationship to Applicant:
Name:
Address:
Comments:
Reference: #3 Relationship to Applicant:
Name:
Address:
Comments:
Phone:
Phone:
Phone:
If you have children, complete the following with their day care provider:
Child Care Provider Commitment Information & Statements
Provider #1 Business Name:
______
Name:
Phone:
Address:
I,______________________, (child care provider name) make a 100% commitment to
_______________(Applicant/potential Student) for child care during the entire enrollment period at
Phagans’ Cosmetology College of the above said person. It is my understanding that I will be
available and responsible for all care and supervision of these children so that the student does not
miss any unnecessary time at college.
Providers Signature:________________________________ Date:________________
Provider #1 Business Name:
Name:
Phone:
Address:
I,______________________, (child care provider name) make a 100% commitment to
_______________(Applicant/potential Student) for child care during the entire enrollment period at
Phagans’ Cosmetology College of the above said person. It is my understanding that I will be
available and responsible for all care and supervision of these children so that the student does not
miss any unnecessary time at college.
Providers Signature:________________________________ Date:________________
Applicants Signature
Date
Revised June 2015
Health & Safety Form
Full Name
City
Address
State
Zip
Physical Demands of the Cosmetology Industry:
A cosmetologist must have good hand eye coordination and be able to stand for long periods of time with limited leg
movement. Nail Technologists and Estheticians require good finger dexterity and coordination, as well as have the
ability to sit for long periods of time. All cosmetology professionals must be able to work long hours while building a
clientele, enjoy working with the public and be able to follow directions. Developing the skills necessary to operate
their own business is a crucial element in establishing a successful career. There are numerous physical and
mental conditions that may limit the ability of an individual to overcome the demands of the industry. It is
recommended that all persons consult with a physician in order to properly assess their mental and physical
motivation, stamina and endurance prior to pursuing a career in the field of cosmetology. (The US Department of
Labor states, “Good health and stamina are important because these workers are on their feet for most of their shift.
Because prolonged exposure to some hair and nail chemicals may cause irritation, special care is taken to use
protective clothing, such as plastic gloves or aprons. Most full-time barbers, cosmetologists, and other personal
appearance workers put in a 40-hour week, but longer hours are common in this occupation, especially among selfemployed workers. Work schedules may include evenings and weekends, when beauty salons and barbershops are
busiest. Barbers and cosmetologists generally are busiest on weekends and during lunch and evening hours,
therefore they arrange to take breaks during less popular times.”)
Health Status: Do you have any medical conditions you would like to inform us of? Yes or No
Medical Conditions:
List Medications taken for treatment:
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Pregnancy: Are you pregnant? Yes or No (If yes, you must fill out Pregnancy Release Form)
Vaccinations: Are all required inoculations (shots) current? Yes or No
Students are highly encouraged to keep all vaccinations current. However, the school does not require proof
of vaccinations for enrollment.
Reasonable Accommodation: Are you requesting any reasonable accommodation? Yes or No
If Yes, please review the Reasonable Accommodation Plan Procedure and Request Form available in the
administrative office.
Medical Emergency Contact:
Name of Physician:
Phone:
In case of a Medical Emergency, whom should we contact?
Name:
Phone:
Relation:
I understand that if any of the above information changes during my enrollment period I am responsible for
notifying the Admissions Department and updating this form.
Applicant signature:
Date:
Revised June 2015
Model References
Shortly after our students begin their cosmetology education they are evaluated in the classroom on
the practical skills they learned. The series of practical evaluations a student must take throughout
their educational program are done on models/guests. The student is required to schedule models
for their evaluations.
Therefore, please provide at least 6 names of people you know that will be willing to be a model for
your practical evaluations if you are accepted for admission:
Model: #1 Relationship to Applicant:
Name:
Address:
Email :
Model: #2 Relationship to Applicant:
Name:
Address:
Email:
Model: #3 Relationship to Applicant:
Name:
Address:
Email
Model: #4 Relationship to Applicant:
Name:
Address:
Email:
Model: #5 Relationship to Applicant:
Name:
Address:
Email:
Model: #6 Relationship to Applicant:
Name:
Address:
Email:
Applicants Signature
Phone:
Phone:
Phone:
Phone:
Phone:
Phone:
Date
Revised June 2015
Estimated Budget Form
Full Name:
Before enrolling in college, you need to analyze and budget for all expenses that you will incur during your
enrollment period. The two main questions you need to answer are:
 How are you going to monetarily support yourself while you are enrolled in college?
 How are you going to pay for your college education?
Expected Income Amount(s): Monthly
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Self
Parents
Spouse
Friend
Work/Job
Other
$
$
$
$
$
$
(you may lose your unemployment benefits if you enroll in college)
Total Income: $
Expected Expense Amount(s): Monthly
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Housing
Utilities
Clothing
House wares
Food
Transportation
Child Care
Health Care
Misc.
Debt Pymts.
College Pymts.
Savings
$
$
$
$
$
$
$
$
$
$
$
$
(Rent /Mortgage, Property Taxes, Insurance)
(Gas, Electric, Water, Phone, Garbage, Cable)
(Purchases, Laundry, Dry Cleaning)
(Household supplies, Furniture)
(Groceries, Restaurants)
(Auto/Bus, Insurance, Gas, Maintenance)
(Daycare provider, Parents, Friends, School)
(Medical Insurance, Prescriptions)
(Personal Care, Entertainment, Other)
(Credit card, Garnishment, Alimony, Child Support)
(Amount you will be paying per month to college)
Total Expenses:
$
**Complete this section with the Financial Aid Administrator**
What does your financial picture look like?
Estimated Total Program Costs:
$_____________.00 (Tuition, kits, books, uniform, manual)
Estimated Self Payments
Estimated Title IV* Grant Aid
Estimated Other Aid
$_____________.00
$_____________.00 (Pell Grants, SEOG)
$_____________.00 (Scholarships, etc)
Estimated Total non-debt Payments/Aid: $_____________.00
*If your total program costs exceed your total non-debt payments/aid you may need to borrow money to attend college. It
is not recommended that you borrow more than you need to pay for schooling costs. All funds, including Title IV Aid
goes first towards paying for tuition, kits, books, and uniforms (ie direct college costs). A loan is money you pay back
with interest over time. It is important that you research average wages in your area so that your debt to income
payments are not more than you can afford. See ‘Wages & Income’ at www.qualityinfo.org
Applicant signature:
Date:
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Revised June 2015