Full Name (Required)

Date of Birth (Required)

Gender (Required)
FemaleMaleOther

Phone Number (Required)

Email Address (Required)

Home Address (Required)

Full Name (Required)

Relationship to Student (Required)

Phone Number (Required)

I understand and agree to pay the non-refundable enrollment fee of $500 TTD at registration.

I understand that tuition, lab fees, and textbook costs are separate and must be paid as per the school’s schedule.

I certify that the information above is accurate and agree to abide by the policies of L’Image School of Aesthetics, including dress requirements (gray scrubs or white jacket) during labs and training.

Digital Signature / Full Name (Required)