Personal Information
First Name: *
Middle Name:
Last Name: *
Nickname:
Date of Birth: *
Gender:
Race:
The Governor's Honor Academy has an equal opportunity policy and does not discriminate on the basis of race, color, natural origin, religion, sex or disability.
T-Shirt Size: *
Address
Street Address or PO Box: *
Apartment/Unit #:
City: *
State: *
Postal Code: *
County:
Contact Information
Home Phone: *
Cell Phone:
Email Address: *
School Information
High School: *
Principal's Name: *
School Phone: *
GPA: *
First 9 Weeks GPA for 11th Grade: *
Will you be a career/technical completer?
If yes, what is your area of study?
Number of AP/IB courses you have been eligible to take:
Number of AP/IB courses you have taken or are taking:
Family Contact Information
Name(s) of Parents:
Father's Home Phone:
Father's Work Phone:
Father's Cell Phone:
Mother's Home Phone:
Mother's Work Phone:
Mother's Cell Phone: