Session Information

All fields marked * are required.

Grade:

7th graders will attend the session at WVU. 8th graders may apply to WVU, National Radio Astronomy Observatory or both.

Did You Attend GSMS 2009?

Eighth-grade applicants please select which session or sessions you wish to attend:

West Virginia University

National Radio Astronomy Observatory

Personal Information

First Name: *

Middle Name:

Last Name: *

Nickname:

Date of Birth: *

Gender:

Female

Male

Race:

American Indian or Alaskan Native

Asian or Pacific Islander

Black, not of Hispanic origin

Hispanic

White, not of Hispanic origin

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: *

Email Address: *

School Information

Your School: *

Principal's Name: *

School's Phone: *

GPA: *

1st Semester Average 2009: *

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: