ENROLLMENT FORM
FOR KLEOPATRA'S SCHOOL OF HAIR WEAVING TECHNOLOGIES

Date: ____/____/____


Name: _______________________________________________________

Address: ______________________________________________________

City, State: ____________________________________________________

Zip: ______________

Telephone: ____-______-______

Date of Birth (optional): ____________________________

E-mail: _______________________________________________________

Form of payment: (Check One)

Credit Card (through Paypal) _____
Money Order _____
Check _____
Other _____ (please specify) _________________________

Questions for enrollment:

1. How did you hear about us? __________________________________________________

2. Is the class strictly for personnal use? __________________________________________

3. Are you a salon owner, a hair stylist, or barber? yes / no ________________

If yes, What is the name of your salon? _______________________________

Mailing address of Salon or Business if different from above:

Address: _________________________________________________________

City/State: ________________________________________________________

Zip: _____________

Office Telephone: ______-_______-_______

4. Have you had any experience in any HAIR WEAVING before? yes / no

If yes, how many years or months of experience do you have? __________________

5. List the techniques of HAIR WEAVING in which you are familiar with?

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________


7. Are you interested in Kleopatra's private courses? Yes / No

8. Are you interested in our Kleopatra's video courses? Yes / No

9. Would you like to enroll in Kleopatra's School of Hair Weaving Technologies? Yes / No

_______________________________________________________________________________

_______________________________________________________________________________

10. Please state why we should accept you into our private school of Hair Weaving Technologies:

________________________________________________________________________________

________________________________________________________________________________

Send your enrollment form to:
Kleopatra's School of Hair Weaving Technologies
3896 Dewey Ave Suite #5309
Rochester, N.Y. 14616

or e-mail your enrollment form to