American Institute of Diamond Cutting, Inc.
MAILING ADDRESS:
1287 E. Newport Center Drive. Suite 202
Deerfield Beach, Florida 33442-4067 USA
Continental US 1-800-831-8470
International (954) 574-0833

APPLICATION FOR ENROLLMENT
THE DIAMOND BUSINESS MANAGEMENT AND MARKETING PROGRAM
SECTION A:
Last Name________________First Name___________Middle Name_____
Street Address___________________________________________________
City/Town_____________________State/Province____________________
Country_______________________US Zip Code_______________________
Country Code____________(if available) Telephone__________________
Country of Citizenship___________Country of birth__________________
Nationality________________________________________ □Male □Female
Applicant's Date of Birth: Month___________Day_______Year________
SECTION B:
Are you a high school graduate:______ Years attended______________
Year of graduation______Name of High School______________________
Country/State____________________________________________________
College or institution of higher learning attended (if any):
(1) Name:____________________(2) Name:____________________________
Address:_____________________ Address:____________________________
(1) Years attended:___________(2) Years attended:___________________
Degrees, diplomas, or certificates received:
(1) a.____________________________(2) a._____________________________
(1) b.____________________________(2) b.____________________________
(1) c.____________________________(2) c._____________________________
List any special training or work experience received in a related field.
(1)__________________________________________________________________________________________________________________________________.
(2)__________________________________________________________________________________________________________________________________.
SECTION C:
Please state your purpose for taking this program. __________________________________________________________________
__________________________________________________________________
Are there special emphasis you would like considered during your training?____________________________________________________________________________________________________________________________.
Do you suffer from any physical disability? □Yes □No
If so, please explain briefly:____________________________________________________________
SECTION D:
I have enclosed with this application:
□
2 Passport size photographs.□
An enrollment fee of U.S. $500.00 (Inclusive of total tuition)□
Complete, sign and date this application.My date of attendance for the diamond business management and marketing program is:
__________-___________to____________-__________. Month Day/Month Day
SECTION E:
Applicant's Signature_______________________First______________Last___________ (Please Print)
Date__________________