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GSE Application Part 1

Student Information

First Name: *

Middle Name:

Last Name: *

Nickname:

Grade:

Birthdate: *
Use the format in the example below
Select a date from the calendar.
T-Shirt Size: *

Gender: *

Race: *The Governor's Schools of West Virginia have an equal opportunity policy and do not discriminate on the basis of race, color, natural origin, religion, sex or disability.

Address: *

Apartment Unit:

City: *

State: *

Postal Code: *

County:

Contact Information

Home Phone: *

Cell Phone:

Active Email Address:

Twitter Account Address:

Instagram Account Address:

School Information

High School: *

Principal Name: *

School Phone: *

Ninth Grade GPA: *

First Nine-Weeks Average Tenth Grade: *

Family Contact Information

Parents' Name:

Father's Home Phone if Different from Yours:

Father's Work Phone:

Father's Cell Phone:

Mother's Home Phone if Different from Yours:

Mother's Work Phone:

Mother's Cell Phone:

Accounting Skill Level:
Computer Programming Skill Level:
App Development Skill Level:
Engineering/Electrical Skill Level:
Leadership Skill Level:
Marketing/Sales Skill Level:
Planning/Details/Problem Solving Skill Level:
Please rank your choices for creative team memphership from 1 to 4:
Hospitality and Tourism (Enter 1-4 Based on Priority)

Healthcare (Enter 1-4 Based on Priority)

Technology (Enter 1-4 Based on Priority)

Creative Economies (Social Impact (Enter 1-4 Based on Priority)


Print Confirmation

If, after clicking "submit," the page does not change, look back over your application for errors or incomplete blanks. If your application transmits successfully, you will receive a pop-up message thanking you for applying to the Governor's School of Entrepreneurship. Print the confirmation page (CTRL-P) and attach it to the top of the paper application.

Attachments
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