* Required

First Namerequired

Last Namerequired

Address 1required

Address 2

Cityrequired

Staterequired

Zip Coderequired

Preferred Phonerequired

Email required

Address must not be previously associated with another person

Date of Birthrequired

MM/DD/YYYY

Gender

Parent or Guardian Name

Additional Parent or Guardian Name

Please send admission materials

Yes

Current Grade

For what grade would you be applying?

Boarding or Day?

Boarding Day

ACADEMIC INFORMATION

Current School

Academic Average (at current school)

ATHLETICS INFORMATION

Heightrequired

Weight

(For wrestling and football prospects)

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!

Please send a confirmation email to the address below: