First Namerequired

Last Namerequired

Address 1required

Address 2

Cityrequired

Staterequired

Zip Coderequired

Preferred Phonerequired

Email required

Date of Birthrequired

MM/DD/YYYY

Gender

Parent or Guardian Name

Additional Parent or Guardian Name

Please send admission materials

Yes

Current Grade

Year of entrance

Fall of 2019 Fall of 2020 Fall of 2021

For what grade would you be applying?

Boarding or Day?

Boarding Day

Will you be applying for need-based financial aid?

Yes No

ACADEMIC INFORMATION

Current School

Academic Average (at current school)

Have you taken the SSAT?

Yes No

SSAT Verbal

SSAT Quantitative

ATHLETICS INFORMATION

Heightrequired

Weight

Select a Fall Sport

Select a Winter Sport

Select a Spring Sport

Favorite Sport

Position(s) played in this sport

High/middle school team name and coach

Coach's email and phone number

Club/select team name and coach

Please list any achievements or relevant statistics regarding this sport

Second Favorite Sport

Position(s) played in this sport

High/middle school team name and coach

Coach's email and phone number

Club/select team name and coach

Please list any achievements or relevant statistics regarding this sport

Third Favorite Sport (if applicable)

Position(s) played in this sport

High/middle school team name and coach

Coach's email and phone number

Club/select team name and coach

Please list any achievements or relevant statistics regarding this sport

List any additional information here

Regarding a campus visit

If you have already scheduled a visit, please tell us when it is scheduled (so that we may notify coaches)

Thank you for your interest in athletics at The Governor's Academy. Go Govs!