Welcome to the Governor’s Honors Program (GHP) 2017 state application. Students must complete all components of the application before it will be considered for state level competition. The first task of the student online application (Provide Contact Information: Primary Parent/Legal Guardian) is designed to collect the correct name and email address of the primary parent/legal guardian. This will generate an email that is sent directly to the primary parent/legal guardian alerting him/her to complete the permission form. The Primary Parent/Legal Guardian Permission form MUST be completed by the primary parent/legal guardian of the nominated student before the student can complete any portion of the online application.

The GHP state application will be available to state nominees for completion beginning November 18, 2016 through January 4, 2017. For more information about the program, please visit the GHP webpage. All GHP applications must be completed using the GHP online application system through FluidReview. No paper applications submitted in lieu of the online application will be accepted and scored.

Students must submit a completed online application by midnight of the deadline, January 4, 2017. The 2017 GHP online application includes the following tasks and components:

• Provide Contact Information: Primary Parent/Legal Guardian• Student Profile (i.e. student information, academic information, short essay response)• Required Assignment(s)• Provide Contact Information: Recommending Teacher• Provide Contact Information: Counselor/Administrative Designee

Note: Incomplete student applications will not be reviewed.

Questions? For technical questions or support for the online application, please contact tech@fluidreview.com. For questions about the program, please contact the student’s local GHP coordinator.

For Reference Only

Governor’s Honors Program 2017 GHP Student Application

Governor’s Office of Student Achievement

Provide Contact Information: Primary Parent/Legal Guardian

The Primary Parent/Legal Guardian form is the first task of the student online application. The nominated student must provide contact information from a parent to begin the online application. The application will ONLY be available in its entirety once the primary parent/legal guardian has completed the parent task.

Please fill in all of the required information about the primary parent/legal guardian in the fields below. The information in this form will be used to send him/her an email to complete the parent permission form. Please be sure to use a valid email address that the primary parent/legal guardian regularly uses. Sometimes these emails may get caught in spam so please ask the primary parent/legal guardian to check their spam folder in the event that they do not see the request.

First Name: Last Name: Email:

Note: If the primary parent/legal guardian does not receive an email within 24 hours, try resending the request. If the primary parent/legal guardian still does not get the email, please contact Trevor Cason (trevor.cason@georgia.gov) and be sure to include the email address of the primary parent/legal guardian.

For Reference Only

Governor’s Honors Program 2017 GHP Student Application

Governor’s Office of Student Achievement

Student Profile

STUDENT INFORMATION Student First (Legal) Name:

Student Last Name:

Preferred Name:

Home Address:

City:

State: Georgia Other

Zip Code:

Home Phone (555-555-1234):

Student Cell Phone (555-555-1234):

Date of Birth (MM/DD/YYYY):

Age: Current grade level: 10th grade

11th grade

Gender: Male Female

Race/Ethnicity: White, non-Hispanic

Spanish / Hispanic / Latino

Black / African American

Asian / Pacific Islander

Multi-Racial

Native American / Alaskan Native

Other

For Reference Only

Governor’s Honors Program 2017 GHP Student Application

Governor’s Office of Student Achievement

Nomination Area Agricultural Science

Communicative Arts

Dance

Engineering (Design Engineering, Mechatronics, Software Engineering)

Mathematics

Music (Brass, Jazz, Percussion, Piano, Strings, Voice, Woodwind)

Science

Social Studies

Theatre

Visual Arts

World Languages (Chinese, French, German, Latin, and Spanish)

For Agricultural Science only, please indicate your favorite/top area of interest in agricultural science from the available choices.

Plant Science

Animal Science

Food Science

Agricultural Technology

Natural Resources

For Engineering only, select a concentration.

Design Engineering

Mechatronics

Software Engineering

For Reference Only

Governor’s Honors Program 2017 GHP Application

Governor’s Office of Student Achievement

For Music only, select a concentration. Music Brass:

Euphonium

Music Brass: French Horn

Music Brass: Trumpet

Music Brass: Trombone

Music Brass: Tuba

Music Jazz: Acoustic or Electric Bass

Music Jazz: Piano

Music Jazz: Guitar

Music Jazz: Saxophone

Music Jazz: Trombone

Music Jazz: Trumpet

Music Jazz: Drums

Music Percussion

Music Piano

Music Strings: Viola

Music Strings: Violin

Music Strings: Cello

Music Strings: String Bass

Music Voice: Treble

Music Voice: Tenor

Music Voice: Bass

Music Woodwind: Flute

Music Woodwind: Bassoon

Music Woodwind: Oboe

Music Woodwind: Clarinet

Music Woodwind: Saxophone

For Theatre only, select a concentration. Theatre Performance

Theatre Design

For World Languages only, select a concentration. Chinese

French

German

Latin

Spanish

For Reference Only

Governor’s Honors Program 2017 GHP Application

Governor’s Office of Student Achievement

Select your school type: Public School

Private School

Homeschool

Select your school district. (If homeschooled, please select the school district you would attend.)

Select your public school.

Select your private school.

Are you a student of a homeschool consortium?

No

Yes. Please specify. ______________________

For Reference Only

Governor’s Honors Program 2017 GHP Application

Governor’s Office of Student Achievement

Primary Parent/Legal Guardian Information Relationship to student Parent/Legal Guardian First Name: Parent/Legal Guardian Last Name: Best Contact Number (555-555-1234):

Parent/Legal Guardian Email Address:

Additional Parent/Legal Guardian Information Relationship to student Parent/Legal Guardian First Name: Parent/Legal Guardian Last Name: Best Contact Number (555-555-1234):

Parent/Legal Guardian Email Address:

For Reference Only

Governor’s Honors Program 2017 GHP Application

Governor’s Office of Student Achievement

Awards, Achievements, and Extra Curricular Activities Please discuss your involvement in any student organizations in which you are a member. Include any positions/roles you currently hold or have held.

Please discuss any school, district, regional, state, or national awards that you have received.

Please discuss any volunteer activities (hours) that you participate in on a regular basis.

For Reference Only

Governor’s Honors Program 2017 GHP Application

Governor’s Office of Student Achievement

Short Essay Response

Include the following items in a detailed well written essay of why you chose to apply to GHP in this area: Why are you interested in attending GHP in this area of study? Why should you be selected to attend GHP? What can you contribute to GHP? What do you expect to gain from GHP? We recommend that students compose and save their essay using a word processing program and copy/paste it into the space provided. (500 words or less) For Reference Only

Governor’s Honors Program 2017 GHP Application

Governor’s Office of Student Achievement

Required Assignment: Social Studies

Submit a short essay discussing the following: Following the 2016 American election the United States now has a new President-elect and Congress. Identify and assess the most significant problems in both domestic and foreign policy facing the newly elected US government, and suggest possible approaches of the new Administration to dealing with or solving one problem in both categories.

We recommend that students compose and save their essay using a word processing program and copy/paste it into the space provided. (500 words or less) For Reference Only

Governor’s Honors Program 2017 GHP Application

Governor’s Office of Student Achievement

Provide Contact Information: Recommending Teacher

Teacher recommendations are an important component of the GHP process and must be submitted before the student application will be considered for state level competition.

First Name: Last Name: Email:

How Do You Know This Person?

Be sure to use a valid email address provided by the individual who will receive this request. Please inform him/her in advance that an email will be sent. These emails may get caught in spam/junk mail folders, therefore the individual should check these folders if the email does not arrive within 24 hours of the request. Note: Nominees may resubmit the request if the email is not received within 24 hours. If the email is still not received, please contact Trevor Cason (trevor.cason@georgia.gov) and be sure to include the individual's correct name and email address.

For Reference Only

Governor’s Honors Program 2017 GHP Application

Governor’s Office of Student Achievement

Provide Contact Information: Counselor/Administrative Designee

Verification forms are an important component of the GHP process and must be submitted before the student application will be considered for the state level competition.

First Name: Last Name: Email:

How Do You Know This Person?

Be sure to use a valid email address provided by the individual who will receive this request. Please inform him/her in advance that an email will be sent. These emails may get caught in spam/junk mail folders, therefore the individual should check these folders if the email does not arrive within 24 hours of the request. Note: Nominees may resubmit the request if the email is not received within 24 hours. If the email is still not received, please contact Trevor Cason (trevor.cason@georgia.gov) and be sure to include the individual's correct name and email address.

For Reference Only