Thank you for visiting Prestige Health and Beauty Sciences Academy. May we ask you to complete a short questionnaire and our representative will respond within 2 days or sooner. Your privacy is of the outmost importance to us. Therefore rest assured that any information you submit is not shared with anyone except the Academy staff. First Name*: Middle Name / Initial: Last Name*: Mailing Address*: City*: State*: Zip/Postal Code*: Country (if other than U.S.)*: Your Email*: Your phone number (including area code)*: Best Time to Contact*: MorningAfternoonOther Personal Information DOB (mm/dd/yyyy)*: Education*: High SchoolCollege (AS)Other Please Indicate Your Specific Area(s) of Interest: Beauty: COSMETOLOGYFULL SPECIALISTNAIL TECHNICIANSKIN CARE/FACIAL Health: DENTAL ASSISTINGMEDICAL ASSISTINGMASSAGE THERAPY In a space below please indicate what additional information you would like us to provide: For security purposes, please type in the following word: Input this code: PRESTIGE HEALTH AND BEAUTY SCIENCES ACADEMY 1250 E Hallandale Beach Blvd, Suite 409, Hallandale Beach, FL 33009. Tel: (305) 395-3458 Fax: (954) 636-7104 E-mail: manager.pba@att.net www.phabsa.com