LGHS
Academy OF Health Careers

2008-2009 Application

Name ____________________________________

Address__________________________________

Phone: ___________________________________

Email (optional): ____________________________________________

Areas of interests in the health field:____________________________________

_________________________________________________________________

Overall Grade average: A   B   C   D

Why you would like to be a part of the LGHS Academy of Health:

_______________________________________________________________

_______________________________________________________________

_______________________________________________________________

List 3 current teacher references/ and what school they can be contacted at:

_______________________________________________

______________________________________________

______________________________________________