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Pre Enrollment Questionnaire
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Step
1
of
2
50%
Which Campus is nearest to you ?
*
-Select one-
Pompano Beach, FL
Gainesville, FL
Ocala, FL
Which program are you interested in ?
*
-Select one-
Cosmetology (1200 hours/40 weeks)
Master Barbering (900 hours/30 weeks)
Restricted Barbering (600 hours/20 weeks)
Full Specialty (600 hours/20 weeks)
Massage Therapy (600 hours/20 weeks)
Instructor Training (600 hours/20 weeks)
Facial Specialty (220 hours/8 weeks)
Nail Specialty (180 hours/6 weeks)
I am unsure
Which program are you interested in ?
*
-Select one-
Cosmetology (1200 hours/40 weeks)
Master Barbering (900 hours/30 weeks)
Restricted Barbering (600 hours/20 weeks)
Full Specialty (600 hours/20 weeks)
Massage Therapy (600 hours/20 weeks)
Instructor Training (600 hours/20 weeks)
Facial Specialty (220 hours/8 weeks)
Nail Specialty (180 hours/6 weeks)
I am unsure
Which program are you interested in ?
*
-Select one-
Cosmetology (1200 hours/40 weeks)
Facial Specialty (220 hours/8 weeks)
Nail Specialty (180 hours/6 weeks)
I am unsure
Full Name
*
Address
Street Address
Address Line 2
City
State / Province / Region
ZIP / Postal Code
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bonaire, Sint Eustatius and Saba
Bosnia and Herzegovina
Botswana
Bouvet Island
Brazil
British Indian Ocean Territory
Brunei Darussalam
Bulgaria
Burkina Faso
Burundi
Cabo Verde
Cambodia
Cameroon
Canada
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos Islands
Colombia
Comoros
Congo
Congo, Democratic Republic of the
Cook Islands
Costa Rica
Croatia
Cuba
Curaçao
Cyprus
Czechia
Côte d'Ivoire
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Eswatini
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Guiana
French Polynesia
French Southern Territories
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Heard Island and McDonald Islands
Holy See
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Isle of Man
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
Korea, Democratic People's Republic of
Korea, Republic of
Kuwait
Kyrgyzstan
Lao People's Democratic Republic
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macao
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
North Macedonia
Northern Mariana Islands
Norway
Oman
Pakistan
Palau
Palestine, State of
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn
Poland
Portugal
Puerto Rico
Qatar
Romania
Russian Federation
Rwanda
Réunion
Saint Barthélemy
Saint Helena, Ascension and Tristan da Cunha
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Sint Maarten
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Georgia and the South Sandwich Islands
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard and Jan Mayen
Sweden
Switzerland
Syria Arab Republic
Taiwan
Tajikistan
Tanzania, the United Republic of
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Trinidad and Tobago
Tunisia
Turkmenistan
Turks and Caicos Islands
Tuvalu
Türkiye
US Minor Outlying Islands
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Venezuela
Viet Nam
Virgin Islands, British
Virgin Islands, U.S.
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Ã…land Islands
Country
Date of Birth
Month
Day
Year
Phone
Email
Enter Email
Confirm Email
Instagram
Facebook Username
Consent
*
By submitting this form, you are giving your express written consent for McDougle Technical Institute to contact you regarding our programs and services using email, telephone or text – including our use of automated technology for calls and periodic texts to any wireless number you provide. Message and data rates may apply. This consent is not required to enroll. You may always call us directly at (954) 972-0635
Program Interest
What appeals to you about the program you selected?
-Select one-
I've been interested in this field for some time
I've been told I would be good at it
I'm not sure why
What research have you done on this program and career path?
-Select one-
I'm just starting my research
I've talked with family and friends
I've researched programs online
I've visited the school and met with an admissions adviser
Is there another program you are also interested in? (Optional)
-Select one-
Yes
No
I also am interested in another program
Have you inquired with any other schools?
-Select one-
Yes
No
If yes
Current Situation
To know where you want to end up, you first need to take a look at where you are right now. In this section we will look at your current situation, how things are going, how they could be different and how you feel about it. The answers you give below will tell you a lot about your motivations and how much you want to change your life.
Are you currently employed?
-Select One-
Yes
No
Are you happy with your current work situation?
-Select One-
Yes
No
It's okay
A year from now if nothing changed, would you feel…
-Select One-
Frustrated. I do not want to be in the same situation a year from now.
About the same. I'm not getting ahead, but not falling behind.
Content. My career is heading in the right direction.
What would you change about your situation? Select all that apply.
Better pay
Better schedule
Work that interests me
Be more respected
Different work environment
Opportunity for advancement
GOALS FOR THE FUTURE
Goals are an important motivator to keep you on track. Take a look at the list of goals below as a way to visualize what your future could look like.
What are some of your goals for the future? Select all that apply.
I want a career where I feel fulfilled
I want a career where I feel I am making a difference
I want a career where my loved ones will be proud of me
I want to make more money
I want to be more independent
I want to give my kids a better life
I want to travel
I want to have more job security
I want to have more financial security
I want to own a home
I want a better life for sure, I just have trouble imagining the details
I have no long-term goals, I prefer living in the moment
I have other goals
What are your other goals?
Why are these goals important to you?
Logistics
Going to school and pursuing a new career does take some planning. On this page we’ll explore some of the details involved in the day-to-day experience. Answer the following questions to determine the logistical elements you have in place to support you going to school
Do you have a high school diploma?
Yes
No
Still in high school
Do you have your GED
Yes
No
I’m in the process of earning my GED
Do you have reliable transportation to get to school?
Yes
No
Do you have young children or dependents requiring care at home?
Yes
No
Do you have access to child / support care?
Yes
No
Have you attended a post-secondary program before?
True
False
Did you complete the previous post-secondary program you enrolled in?
True
False
School Match
We’re proud of the education we offer and our many successful graduates. However, we’re not right for every student. Answer the following true or false to identify if you are a match:
I want an education that is focused on a specific beauty and/or wellness career path
Yes
No
I learn best hands-on
Yes
No
I am comfortable using a computer
Yes
No
It is important to me that the school helps me with job placement after graduation
Yes
No
I want training I can complete in less than a year
Yes
No
I learn better in a small class environment
Yes
No
My instructors should have real-world experience in their field
Yes
No
I learn better in a small class environment
Yes
No
Your Support System
Use the tool below to identify some of your key supporters:
Moral Support
This person will help me make good decisions and keep me focused on my goal. (Click + to add additional supporters)
Name
Relationship
Add
Remove
Financial Support
This person will help me pay for school and help cover living expenses. (Click + to add additional supporters)
Name
Relationship
Add
Remove
Lifestyle Support
This person will help me with things like childcare, transportation, etc. (Click + to add additional supporters)
Name
Relationship
Add
Remove
Is there anyone who is NOT supportive of your education plans? (Optional)
(Click + to add additional people who are NOT supporters of your plan)
Name
Relationship
Add
Remove
Is there anything that is currently preventing you from moving forward at this point?
Yes
No
List the issue(s) that is preventing you from moving forward at this point?
(Click + to add additional issues)
Add
Remove
Next Steps
Next Steps
I am ready to enroll. I do not need to schedule a personalized tour.
I would like to schedule a personalized tour of the campus.
You will meet with an Admissions Representative who will give detailed program and schedule information. You can get a tour of our campus and get introduced to some of our faculty. An Admissions Representative can also check to see if you qualify for any scholarships, grants, and assist you with a payment plan if needed.
Other
Select what you'd like to have covered during this meeting (you can choose as many as you'd like):
Get a tour of the campus
Discuss program details
Discuss start dates
Discuss my career path/goals
Go over schedule
Discuss financial assistance options
Discuss scholarships and grant (subject to availability)
Meet with a faculty member
Talk with some current students
Other
Do you have any other questions or comments?
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