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
FANCY COLORED DIAMOND PROGRAM.
Tuition: U.S. $2,500.00 Clock Hours: 30
Enrollment Fees: $150.00 Duration: 1 week
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. $150.00 (Inclusive of total tuition)□
Complete, sign and date this application.My date of attendance for the Fancy Colored Diamond Program is:
__________-___________to____________-__________. Month Day Month Day
NOTE: Please call the Institute to arrange a mutually agreed class schedule. Class dates should be arranged as early as possible since other students are also scheduled throughout the year.
SECTION E:
Applicant's Signature_______________________First______________Last___________ (Please Print)
Date__________________