Apply Now

We are excited that you are considering the Aesthetics Institute! To apply, please submit the application form below. After submitting the application, a $25 application fee must be received by the Institute before your application is processed.

If you have difficulty with the application, please call us at (503) 238-1793

Contact Information

*Name (first,middle,last)

*Current Address (Street, City, State, Zip)

*Permanent Address (Street, City, State, Zip)

*Primary Contact Number	Secondary Contact Number	*Email Address
() -	() -
*Date of Birth	*Marital Status	*Age of Dependents (separate with coma)

*Emergency Contact (Name, Address, Telephone)

Course Information

*Pick Course(s)	*Pick Desired Schedule	*Pick Start Month	*Anticipated Payment Plan
Esthetics- Basics
Esthetics- Masters
Electrology
Nail Technology

Past Education

*Did you graduate from high school?	*If you have attended another school, where?	*If you have had previous relevant skills or training, would you like to be evaluated for advanced placement?

Employment Information

Date Begin	Date End	Employer	Phone Number	Duties
			() -
			() -
			() -
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Physical Information

Physical information is not considered in determining acceptance to the Institute. It is to ensure that we can accommodate any accommodation that you might require.

*In general, how do you consider your health?

If Poor, Explain:

*Please list any physical or mental conditions which could interfere with your training or attendance: (If none, type n/a)

*Please list any medical conditions or medications the faculty should be advised of: (If none, type n/a)

*Name and phone number of your family doctor: (If none, type n/a)

Conditions of Enrollment

I expect to enter the college as indicated in the application above, subject to my acceptance by the Aesthetics Institute. If accepted, I intend to put forth my best efforts to successfully complete my training. I do allow the school to use my name and/or photograph for its publicity. It is understood that a $25.00 application fee is required.

I understand that after I submit my application the Aesthetics Institute will send to my email address an invoice for the $25 application fee. This can be paid via debit/credit card through PayPal. I can also elect to pay through the invoice or send a check to the Institute at 2245 SE Powell Blvd, Portland, OR 97202.

The information submitted above is true and accurate. I agree to the conditions of enrollment.