Personal Information

Email *

First Name *

Last Name *

Date of Birth *

Social Security Number *

Street Address *

City *

State *

Zip Code *

Phone Number *

Email Address *

Citizenship or Residency Status *
U.S. CitizenU.S. Permanent Resident (Green Card Holder)International Student with Visa (Specify Visa Type)Deferred Action for Childhood Arrivals (DACA) RecipientRefugee or AsyleeOther (Specify)

Location *

Fort Collins, ColoradoThornton, ColoradoCentennial, ColoradoDearborn, Michigan

Dollar Amount Requested for Financing? *

What Is the Starting Month of the Program You Are Joining? *

Which Program Are You Enrolling In? *
EstheticsPermanent Make UpCosmetic InjectablesOther

Loan Terms *

Loan amount requested and approved will be limited to the cost of tuition.

Interest will accrue at an annual fixed rate based on credit worthiness.

Loan funds will be disbursed directly to Lash & Company.

Repayment period is 36 months.

Prepayment without penalty is allowed.

A loan is in default if payments are 60 days overdue.

Co-signers share equal responsibility.

Loans may be canceled or discharged under limited circumstances.

Borrower must notify lender of any changes.

Disclosure and Acknowledgment *

I acknowledge and agree to the above terms.

Account Information

Account Holder Name (First and Last) *

Name of Bank *

Routing Number *

Confirm Routing Number *

Account Number *

Confirm Account Number *