Address: 4840 Roswell Rd. Building E Suite 200, Sandy Springs, Georgia, 30342, US
Telephone: (404) 256-5228

Please complete the application. Once completed, please pay your application fee online or contact the Admissions Director.

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Full Legal Name

Social Security Number

Date of Birth

Street Address

Apt, suite, etc.

Country

City

State

Zip code

Mailing Address (If Different)

Apt, suite, etc.

Country

City

State

Zip code

Contact Phone Number

xx-xxx-xxxx

Email

Citizenship

U.S. Citizen

Immigrant-Permanent Resident

Non-resident Alien, Country of Citizenship (Provide copy of I-155 or I-151)

Have you ever been convicted of a crime? *

Yes

No

If you answered yes in the previous question, please explain.

I plan to enroll for

Full-Time (day classes)

Full-Time (no Saturdays)

Part-Time (evening classes)

Program(s) I am interested in

Esthetician Program

Nail Care

Massage Therapy

Date to begin

Will you be using VA benefits?

Yes

No

If you said yes to the previous question please provide your, VA Chapter Number

Enter your Chapter number for VA (e.g. chapter 33)

How did you hear about us?

Web Search

Advertising

Word of Mouth/Referral

Describe the attributes within you that make you an ideal candidate for ESI. *

Emergency Contact

Emergency Phone Number

xxx-xxx-xxxx

Please list the high school and colleges you have attended. Have transcripts sent to The Elaine Sterling Institute admissions office.

School

Dates

School

Dates

School

Dates

Submission

Please follow up on your status of your application within 48 hours at (404) 256-5228.

Online Application

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