Aveda Institute Des Moines Admissions Application

Mailing Address *

Permanent Address

Education Intent

Note: Changing a start date after application submission will result in a $50 fee.
AIDM Program *

Cosmetology Esthiology Massage Therapy
Start Date *
/ Month / Day Year
Have you attended an AVEDA Institute? *

No Yes
What AVEDA Program did you attend? *
What was the former start date? *
- Month - Day Year

Financial Intent
How will you be paying for school? *

Upfront Payment Payment Plan Sallie Mae Loan* Federal Student Aid
Name of cosigner *
Have you completed a FAFSA form? *

Yes No
*Please note that the AVEDA Institute Des Moines does not participate in a Preferred Lender Arrangement and a student may use any lender of their choice who will approve a personal loan.

Criminal Background
Have you ever been convicted of a felony? *

No Yes
Please give the nature of the offense, the date, the court & the sentence imposed: *
A conviction will not necessarily disqualify you from acceptance.

Address *

Additional Information
Please provide any additional information regarding special circumstances, additional qualifications, etc. All information provided in this application is kept strictly confidential. *

Request for Confidential Information
The information requested below is voluntary. It may be used in reporting under federal and state laws and regulations. It will not be used as a basis for admission or in any discriminatory manner
Date of Birth
- Month - Day Year
Gender Identity
Residency

Iowa Resident Other State International Student
State
From Country
Predominant Ethnic Background
Other Ethnic Background
Age Group
Highest Level of Education Completed
Family Income
If you are a Dependent, include parents' income; If Independent, include yourself and if married, your spouse.

Student Certification
I CERTIFY THAT THE INFORMATION I HAVE PROVIDED FOR ADMISSION TO THE AVEDA INSTITUTE DES MOINES IS COMPLETE & ACCURATE TO THE BEST OF MY KNOWLEDGE. I UNDERSTAND THAT THE MISREPRESENTATION OF INFORMATION IS SUFFICIENT GROUNDS FOR CANCELING ADMISSION TO THE AVEDA INSTITUTE DES MOINES.
Signature
Date
/ Month / Day Year
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Personal Information