Personal Information
Student Information
First Name: *
Middle Name:
Last Name: *
Nickname:
Birth Date: *
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.
Address Information
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: *
Ninth Grade GPA: *
First 9 Weeks GPA for 10th Grade: *
Family Contact Information
Father's Name:
(or legal guardian)
Father's Daytime Phone:
Father's Evening Phone:
Mother's Name:
Mother's Daytime Phone:
Mother's Evening Phone:
Arts Area for Which I Am Applying
What Instrument?
Audition
Schedule my Audition for: *
Attachments