Enrollment Fee / Student Permit

Legal Name*

First Last

Cell Number*

Email*

Address*

Street Address City State ZIP Code

Date of Birth*

What Program are you interested in?*

1000 Hour Barber

1000 Hour Cosmetology

600 Hour Nail Tech

750 Hour Advanced Esthetician

800 Hour Manicure / Esthetician Combo License

320 Hour Lash Extension

300 Hour Crossover - Cosmetology to Barber (Must have an Cosmetology License)

300 Hour Crossover - Barber to Cosmetology (Must have an Barbers License)

500 Hour Massage Therapy – Coming Soon

Class date you're interested in?*

Which Enrollment Representative At Champions Academy has helped you?*

Mr. Glen

Mrs. Lorraine

I want to pay my

Enrollment Fee

TDLR Student permit

(Non-refundable, but transferrable to another class date)

Non-Refundable Enrollment Fee

Price:

TDLR Student permit

Price:

Payment Method*

ACH - Routing and Checking Acct #

Credit Card - 3.99% fee is applied

Credit Card*

American Express

Discover

MasterCard

Visa

Card Number

Expiration Date

Security Code Cardholder Name

ACH*

Account Number Account Type Routing Number Account Holder Name

3.99% Credit Card Fee

Price: $0.00

Total

Signature*

Confirmation #

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Student Salon & Spa Hours

Student Hours / Scheduled Hours

Monday	Closed
Tuesday	11 AM – 7:15 PM
Wednesday	11 AM – 7:15 PM
Thursday	11 AM – 7:15 PM
Friday	11 AM – 4:00 PM
Saturday	9 AM – 2:00 PM
Sunday	Closed

Monday	5 PM – 9 PM
Tuesday	8:45 AM – 9 PM
Wednesday	8:45AM – 9 PM
Thursday	8:45AM – 9 PM
Friday	8:45 AM – 5 PM
Saturday	8:45AM – 3 PM
Sunday	Closed