2006-2007 Application Form
 

Academic School for Interior Design

941.342.7942
Complete and sign this form.
Include application fee of $25.00 and return to:  1646 Oak View Dr., Sarasota, Florida 34232

The school accepts checks or money orders made payable to Academic School for Interior Design. 

Name                                                                                                      Social Security Number

Birthdate                                                                                                 Place of Birth

City                                                                     State                                       Zip Code                       Country

Permanent Telephone                                          Fax Phone                                            E-mail Address

Personal Date (circle)              Female                  Male                        Single                     Married                           Divorced

Level of Education (circle one)    Grade 8-12            Vocational School                1-2 Years College                 3-4 Years College

If you have graduated from any secondary school, what was the degree you obtained?

Have you had any work experience in the field of interior decorating, interior design or architecture?  If so, please detail:

Current Employer                                                                                                            How long?

Street Address                                                                        

City                                                                     State                                       Zip Code                       Country

Telephone                                          Fax Phone                                            E-mail Address

Supervisors Name                                                                                          Telephone Extension

Prior Employer                                                                                                            How long?

Street Address                                                                        

City                                                                     State                                       Zip Code                       Country

Telephone                                          Fax Phone                                            E-mail Address

Supervisors Name                                                                                          Telephone Extension

By signing this form, I attest that all of the above is true.  I understand that I must pre-pay in full with a check or money order for each CH (Contact Hour) segment at $10.00 per CH.  I agree to send an administration fee of $25.00 along with each completed CH segment to be used for registration of that CH to my transcript.  I understand that this is a non-degree certificate program in interior design.  I understand that I must maintain an average of a C (70% or above) and complete 500 CH's to graduate from the Certificate Program.  I agree to pay a fee of $35.00 for any returned checks.  By signing this, I agree to abide by all the rules as set forth by the school.  

Signature                                                                                                                                                                            Date