5250 Lankershim Boulevard, North Hollywood, CA 91601 PHONE: (818)299-5100 FAX: (213)251-4928 www. artinstitutes.edu

APPLICATION FOR ADMISSIONS
Administrative/Enrollment Fee: $100.00 Application Fee: $50.00
}}

Applicant Information Applicant Name
Butler, Alexandria {{!slc_FullName_es_:Signer1:textfield

Maiden/Other Name
{{!slc_MaidenName_es_:Signer1:textfield}}

Primary/Home Phone
242-364-1175 {{!slc_telephone2_es_:Signer1:textfield }}

Mobile Phone
242-465-6469 {{!slc_mobilephone_es_:Signer1:textfield }}

Email alexandria_butler@hotmail.com {{!slc_emailaddress1_es_:Signer1:textfield }}

Current Address Address 1
Armbrister Steet {{!slc_address1_line1_es_:Signer1:textfield }}

State/Province
British Columbia {{!slc_address1_stateid_es_:Signer1:textfield }}

Address 2
{{!slc_address1_line2_es_:Signer1:textfield }}

Zip/Postal Code
00000 {{!slc_address1_postalcode_es_:Signer1:textfield }}

City
Nassau {{!slc_address1_city_es_:Signer1:textfield }}

Country
Bahamas {{!slc_address1_countryid_es_:Signer1:textfield }}

Permanent Address if different from Current Address Address 1
Armbrister Steet {{!slc_address2_line1_es_:Signer1:textfield }}

State/Province
British Columbia {{!slc_address2_stateid_es_:Signer1:textfield }}

Address 2
{{!slc_address2_line2_es_:Signer1:textfield }}

Zip/Postal Code
00000 {{!slc_address2_postalcode_es_:Signer1:textfield }}

City
Nassau {{!slc_address2_city_es_:Signer1:textfield }}

Country
Bahamas {{!slc_address2_countryid_es_:Signer1:textfield }}

Program of Study Program of Study
Fashion Design - Associate of Science {{!slc_ProgramofStudyId_es_:Signer1:textfield }}

Concentration
{{!slc_AreaofStudyId_es_:Signer1:textfield }}

Start Date
8/20/2015 {{!slc_StartDateID_es_:Signer1:textfield }}

5250 Lankershim Boulevard, North Hollywood, CA 91601 PHONE: (818)299-5100 FAX: (213)251-4928 www. artinstitutes.edu

APPLICATION FOR ADMISSIONS

Educational Background The applicant is responsible for providing The Art Institute of California –Hollywood, a campus of Argosy University with all copies of official High School Transcripts and/or GED scores of the applicant. If the applicant is requesting early acceptance before completion of high school, the applicant is responsible for providing to the school copies of partial transcripts as well as final transcripts from high school upon graduation. I verify that I:
Will graduate from High School {{!slc_VerifyHighSchoolGradGED_es_:Signer1:textfield }}

Name at Time of High School Attendance:
{{!slc_HighSchoolStudentName_es_:Signer1:textfield }}

Graduation or GED Date: Month
6 {{!slc_HighSchoolGradMonth_es_:Signer1:textfield }}

Year
2015 {{!slc_HighSchoolGradYear_es_:Signer1:textfield }}

Name of High School or Testing Center
Doris Johnson Senior High School {{!slc_HighSchool_es_:Signer1:textfield }}

City
Nassau {{!slc_HighSchoolNotListedCity_es_:Signer1:textfield }}

State
FL {{!slc_HighSchoolNotListedStateid_es_:Signer1:textfield }}

Attended College or University
False {{!slc_AttendedCollegeUniversity_es_:Signer1:textfield Institution {{!slc_CollegeNameNotListed1_es_:Signer1:textfield}} Degree Earned {{!slc_CollegeDegreeObtained1_es_:Signer1:textfield}} }}

{{!slc_CollegeNameNotListed2_es_:Signer1:textfield}}

{{!slc_CollegeDegreeObtained2_es_:Signer1:textfield}}

{{!slc_CollegeNameNotListed3_es_:Signer1:textfield}}

{{!slc_CollegeDegreeObtained3_es_:Signer1:textfield}}

{{!slc_CollegeNameNotListed4_es_:Signer1:textfield}}

{{!slc_CollegeDegreeObtained4_es_:Signer1:textfield}}

{{!slc_CollegeNameNotListed5_es_:Signer1:textfield}}

{{!slc_CollegeDegreeObtained5_es_:Signer1:textfield}}

{{!slc_CollegeNameNotListed6_es_:Signer1:textfield}}

{{!slc_CollegeDegreeObtained6_es_:Signer1:textfield}}

{{!slc_CollegeNameNotListed7_es_:Signer1:textfield}}

{{!slc_CollegeDegreeObtained7_es_:Signer1:textfield}}

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5250 Lankershim Boulevard, North Hollywood, CA 91601 PHONE: (818)299-5100 FAX: (213)251-4928 www. artinstitutes.edu

APPLICATION FOR ADMISSIONS

Military Information Do you have a Military Affiliation?
False {{!slc_MilitaryAffliation_es_:Signer1:textfield }}

Type
{{!slc_MilitaryAffiliationType_es_:Signer1:textfield }}

Branch
{{!slc_MilitaryBranchofService_es_:Signer1:textfield }}

International Student Information Are you a:
International {{!slc_CitizenshipId_es_:Signer1:textfield }}

If you are living in the U.S., what is your Visa Status?
Student {{!slc_InternationalVisaStatus_es_:Signer1:textfield }}

The Art Institute of California -Hollywood, a campus of Argosy University requests information regarding citizenship status for funding and admission requirements only. The Art Institute of California -Hollywood, a campus of Argosy University does not use this information in any way to exclude prospective students on the basis of citizenship status or any other protected characteristic.

Additional Information Present Knowledge of English
Primary {{!slc_InternationalEnglishKnowledge_es_:Signer1:textfield }}

TOEFL Taken
False {{!slc_TOEFL_es_:signer1 }}

History of Felony
False {{!slc_ConvictedPledGuiltyCrime_es_:signer1 }}

A "Yes" answer to the above question does not mean the automatic rejection of your application. Applicants should be aware that the licensing requirements of some states may mean that a criminal conviction could restrict your ability to practice in your chosen field. Description
{{!slc_DescribeConvictionPledGuiltyCrime_es_:Signer1:multiline }}

Applying for Federal Financial Aid
True {{!slc_PlantoApplyFederalFinancialAid_es_:signer1 }}

Have you spoken with anyone in the admissions office?
True {{!slc_SpoketoAdmissionsOffice_es_:signer1 }}

Representative Name
Hoyle Angela M. {{!slc_SpokentoAdmissionsOfficeName_es_:Signer1:textfield }}

Do you desire assistance in seeking part-time employment while in school?
True {{!slc_EmployerPartTimeEmployment_es_:Signer1:textfield }}

Will you need a student non-immigration visa to attend this school?
True {{!slc_InternationalNonImmigrantVisa_es_:Signer1:textfield }}

If you attend the school, will you desire assistance in finding school-sponsored housing?
True {{!slc_DesireSchoolSponsoredHousing_es_:Signer1:textfield }}

5250 Lankershim Boulevard, North Hollywood, CA 91601 PHONE: (818)299-5100 FAX: (213)251-4928 www. artinstitutes.edu

APPLICATION FOR ADMISSIONS

Essay I will submit my essay:
True By mail: {{!slc_EssaySubmissionMethod_es_:Signer1:textfield Online: {{!iffield_es_:Signer1:calc(if(slc_EssaySubmissionMethod, False, True)) {{!slc_Essay_es_:Signer1:multiline Fashion Design - Associate of Science }} }} }}

{{[x]!}}

By checking this box, I certify that I have independently conceived and written the essay.

5250 Lankershim Boulevard, North Hollywood, CA 91601 PHONE: (818)299-5100 FAX: (213)251-4928 www. artinstitutes.edu

APPLICATION FOR ADMISSIONS

Disclosure and Consent to Receive Student Account Information Electronically and to Use Electronic Signatures Thank you for your interest in receiving information electronically from The Art Institute of California - Hollywood, a campus of Argosy University, and its corporate parents, subsidiaries and affiliated companies (collectively, the “Campus,” “we,” “us,” or “our”), and signing Campus documents using electronic signatures. Before you can complete Campus documents online and receive information, including student account-related information, electronically, you must consent to receive information and disclosures electronically and agree to the use of electronic signatures on documents related to your relationship with us. Please review the information below prior to giving your consent and agreement. We recommend that you print a copy of this Disclosure and Consent, which includes this document and all of its contents, and maintain a copy for your records. Electronic Consent Please print and retain a copy of this Disclosure and Consent for your records.

1.

Scope of Consent. By accepting the Disclosure and Consent, you agree that the Campus may provide you with the following categories of records and information in electronic format only instead of providing a paper copy to you, and you consent to use electronic signatures in connection with transactions involving such records and information (“Records”). Records to be provided electronically may include: a. Academic Affairs Documents, including but not limited to FERPA Release Requests, Graduation Applications, Release of Information to Third Parties, and Student Verification Request Forms. b. Admission Documents, including but not limited to Enrollment Agreements, Applications for Admission, Learning Center Agreements, Student Acknowledgement Forms, Student Disclosure Forms, Timeline Agreements, and Transcript Request Forms. c. Career Services Documents, including but not limited to Educational Waivers, Employer Verification Letters, and Student/Graduate Verification Letters. d. Financial Aid Documents, including but not limited to Authorizations to hold, release, or return funds including Title IV funds, Award Letters, Dependent and Independent Verification Worksheets, Financial Aid Applications and Planning Applications, Institutional Applications, Payment Option Policy Agreements, and Student Authorization to Hold or Use Funds. e. Student Accounts Documents, including but not limited to Return Loan Requests and Student Authorization, Stipend Requests, and Refund Requests. Student Account means your online access to your personal institutional records and agreements, as well as disclosures and other documents issued by the Campus. f. Miscellaneous Documents, including but not limited to any disclosure, consent, waiver, release, notice or payment reminder that would normally be delivered in writing that may be required by law or regulation. These documents will be provided to you electronically by such means as the Campus shall determine in its discretion, including but not limited to email (or a link set forth in an email), or the student portal. Your consent will continue to be effective unless you withdraw it in the manner provided below. We may provide Records to you electronically by posting them online or by email, which may include attachments or embedded links. We reserve the right to provide you paper communications at any time. We also reserve the right to send records or information to you electronically even if you decline to accept this Disclosure and Consent to the extent we are permitted to do so by law.

2.

Withdrawal of Consent. If you do not consent, you will not be able to receive your student account information and disclosures electronically and the Campus may require you to sign all Campus documents with a physical signature. You have the right to withdraw consent to receiving information electronically by making written request to The Art Institute of California - Hollywood, a campus of Argosy University’s Registrar, 5250 Lankershim Boulevard, North Hollywood, California 91601.You agree to receive documents electronically for a reasonable amount of time after your withdrawal of consent is received.

5250 Lankershim Boulevard, North Hollywood, CA 91601 PHONE: (818)299-5100 FAX: (213)251-4928 www. artinstitutes.edu

APPLICATION FOR ADMISSIONS

3.

Paper Copies. To obtain a paper copy of your documents, print the document(s) from the screen on your personal computer. You can also download the document(s) with disclosures to your hard drive or other storage device. To obtain a duplicate copy of your documents in paper form (a) send a written request to The Art Institute of California - Hollywood, a campus of Argosy University’s Registrar, 5250 Lankershim Boulevard, North Hollywood, California 91601 or (b) visit The Art Institute of California - Hollywood, a campus of Argosy University, 5250 Lankershim Boulevard, North Hollywood, California 91601 to request a specific document. Requests for paper copies of these documents will be subject to reasonable fees for copying. Hardware and Software Requirements. To access your account-related information, you must have a personal computer (PC) or Macintosh computer with a working connection to the Internet. Your Internet browser software must support 128-bit encryption and you will need required software, such as Adobe Acrobat Reader and Microsoft Word. Please access the following link for information concerning computer specifications and connecting to the campus network: http://www.artinstitutes.edu/hollywood/student%2Dconsumer%2Dinformation/academic%2Dawareness.aspx 4.

Students must access program requirements to obtain program specific hardware and software requirements. At the option of the Campus, information may also be sent to The Art Institute of California - Hollywood, a campus of Argosy University e-mail address. Please modify your e-mail security to allow e-mails from us. It may be necessary to notify your Internet service provider that this is an allowable e-mail. From time to time, we will conduct system upgrades. We will inform you of any revised hardware or software requirements that may be in effect after an upgrade to allow you to continue to access your student account and disclosures electronically. You agree to keep us informed of your current contact information, including your physical address, by sending such changes in the student portal to The Art Institute of California - Hollywood, a campus of Argosy University Registrar’s Office at the address shown above. By electronically signing documents, you agree to all the terms and conditions of such documents. The Campus may retain and store the executed documents in electronic format. An electronic record of a signed document will be deemed to be the original, signed document for all purposes. If any provision of the foregoing Disclosure and Consent is deemed invalid, illegal or otherwise unenforceable, we agree that it shall be modified to the minimum extent necessary to render it valid, legal and enforceable. If a provision cannot be modified in a manner that would make it valid, legal and enforceable, the provision shall be severed, and all other provisions shall remain in full force and effect. Any failure on our part to enforce any of the terms of the foregoing terms of the Disclosure and Consent or to exercise any right shall not be considered a waiver of our right to enforce each and every such term or exercise such right or any other right.

False {{!slc_AcknowledgeAcceptDisclosureandConsent_es_:Signer1:textfield

}}

Accept : By selecting “Accept” I acknowledge that I read, understood, and agree to this Disclosure and Consent.
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Decline : You have chosen not to consent to the submission and receipt of information electronically and to electronically sign application documents. We reserve the right to send you records or information electronically even if you decline to accept this Disclosure and Consent to the extent we are permitted to do so by law. 11/18/2014 10:06:49 PM {{!slc_AcknowledgeAcceptDisclosureandConsentDate_es_:Signer1:textfield }}

5250 Lankershim Boulevard, North Hollywood, CA 91601 PHONE: (818)299-5100 FAX: (213)251-4928 www. artinstitutes.edu

APPLICATION FOR ADMISSIONS

Gainful Employment Since The Art Institutes is comprised of several institutions, see aiprograms.info for program duration, tuition, fees and other costs, median debt, federal salary data, alumni success, and other important info.

Signature of Applicant All information provided above is true and complete to the best of my knowledge. I understand that admission to The Art Institute of California -Hollywood, a campus of Argosy University is contingent upon submission of my final official high school transcript (or my official G.E.D. test result), all post- secondary transcripts, satisfaction of all admissions criteria, my acceptance by The Art Institute of California -Hollywood, a campus of Argosy University, my signing of The Art Institute of California -Hollywood, a campus of Argosy University’s Enrollment Agreement, and The Art Institute of California -Hollywood, a campus of Argosy University's acceptance of the application. Applicant Name:
Butler, Alexandria {{!slc_FullName_es_:Signer1:textfield
Signature:

}}

Date
}} {{Dte_es_:signer:date }}

{{Sig_es_:signer:signature

The Art Institute of California -Hollywood, a campus of Argosy University does not discriminate on the basis of race, color, creed, religion, national origin, ancestry, sex, age, sexual orientation or disability, or any other characteristic protected by state, local or federal laws in the administration of any of its educational programs or activities or with respect to admission or employment. The Art Institute of California -Hollywood, a campus of Argosy University is a member of The Art Institutes, one of the nation's leaders in career-oriented education for the creative arts. In the event that your telephone number is registered on the National Do Not Call Registry, the signature above gives consent for The Art Institute to call you for 18 months or up until the designated time of your class start, which ever comes later. Parents must sign for any student under the age of 18 years of age.

Request for an Official High School Transcript

The Art Institutes Transcript Processors 1400 Penn Avenue Pittsburgh, PA 15222-4332 Phone: 412-518-5878 Fax: 412-992-5948

To Counselor/Registrar: Please mail an OFFICIAL transcript to The Art Institutes at the address listed above. Please make certain the transcript lists Date of Graduation and SAT/ACT scores. In addition, please fax a transcript prior to mailing to 412-992-5948.
Please Print All Information (*required)
*First Name Middle Initial *Last Name

Alexandria
*Full Name at Time of Graduation (if different from above) *SSN

Madrina Butler
*The Art Institute Campus Location *Date of Birth

The Art Institute of California - Hollywood
Phone

4/2/1998

Address

Armbrister Steet
City State Zip

Nassau
I verify that I:

British Columbia
I graduated/tested in (yr)

Will graduate from High School
*High School/GED Testing Center

2015

Doris Johnson Senior High School
*Address *City *State *Zip

Nassau
School Phone (Official Use Only) Payable to:

FL
Fax

Notes:

I certify that I have graduated from the high school indicated above, or have received the GED indicated above. I authorize you to release my official transcript or GED certificate to The Art Institutes.
Signature Date

For Official Use