*Student Intake

Ke Kō Student Intake Form

Please fill out the information below upon enrolling in class. This information is used to create your student account, online class verification/shipment of kits and final exam certificate & any upcoming news post graduation. Thank you! Your Ke Kō Education Ohana
Educator Name *
please note *online course if not taking a one on one class
Student Name *

First Name Last Name
Who can we thank for referring you to our program? *
Student Picture *

Browse Files
Please submit a picture of yourself so we can put a face to your name! Especially all you online aspiring Sugarists! Cancel of
Please select which class student is enrolled in. *
Class Location *
First Class Day *

Month Day Year
Date
Student Email *
example@example.com
Student Professional License Number/If in school please list graduation date *
Student Mailing Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Student Phone Number *

Area Code Phone Number
Virtual Class Promissory

Please take a moment to read through and sign prior to admission into class.
Here at Ke Kō we pride ourselves in giving the best of the best education. In doing so we want to also protect our models and the hard work put into these classes. With registering for this course you are also agreeing to abide by these rules below.
- You promise to NOT video or replicate this course in any way
- You promise to NOT share the class link with anyone NOT registered for this course
- You understand our Policies , Disclaimers, Terms of Use and Privacy Notice
- You understant our Return Policy
Today's Date *

Month Day Year
Date
Signature in Agreement to above Promises *

Clear
Should be Empty:

Ke Kō Student Intake Form

Virtual Class Promissory