2023 Application Form

Application for National History Academy

For 10th, 11th, and 12th Grade Students

2023 Residential Program Application

Student Information
Student Name*
First Last
Age*
Gender*
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Student Email*
Student Phone*
Academic Information
High School*
My School is a:*
What year do you anticipate graduating high school?*
Current GPA*
If your school does not use a 4.0 GPA scale, please indicate the scale. Please also indicate if your GPA is weighted.
GPA Scale / Weight
AP US History Exam Score
AP World History Exam Score
PSAT Score
SAT Score
ACT Score
How did you hear about the National History Academy?*
Essay Question
Please answer one of these questions.*
- Which historical site has had the biggest impact on your life? Why?
- Which historical site would you most like to visit? Why?
Answer (2 paragraphs)*
Parent Information
Parent/Guardian Name*
First Last
Email*
Phone*
Best time to call*
Financial Aid
Financial aid is available on a need-basis. Students who indicate they are applying for financial aid must complete the following section in full. This information will not be shared, but is required to determine eligibility.
Do you plan to apply for need-based financial aid?*
- No, I do not plan to apply
- Yes, I plan to apply
Annual Household Income
Size of Household

Please indicate the number of adults, children, grandparents, etc. residing in the house.
Do you currently receive free or reduced lunch at school?
- Yes
- No
Parent/guardian 1 place of employment
Parent/guardian 2 place of employment
What amount of tuition are you able to pay?
Do you have any special circumstances we should be aware of as we evaluate your request for financial aid?
Health and Safety
Due to COVID-19, NHA is following local guidelines. Students may be required to wear a mask as some locations, and social distance when necessary.
Vaccination Status
- Up to date on COVID vaccines
- Not up to date on COVID vaccines
Confirmation
I confirm that the information supplied above is accurate.
Student Signature*
Parent Signature*