Hamburg Health Science Academy Application
1.  Please review all curriculum and Health Science Academy requirements before completing
     the application. Information can be found in the school course offering booklet, your school counselor, or
     an academy teacher.

2.  Submit this completed application by Friday March 14, 2025.

3. Teacher Recommendations: Two teacher recommendations (one a middle/high school science teacher) must be turned in by March 14,2025. Ask  a current or past high school/middle school teacher if they would be willing to complete a short recommendation form on your behalf. Then email the teachers this link:   HSA Teacher Recommendation Form

4.  HSA Interview: After we receive your completed application and teacher recommendations, you will receive an email stating the day, time, and location of your interview.  The email will also let you know when the optional after school informational meeting will be held to help you prepare for the interview. 

5. Acceptance letters will be mailed at the end of April.

We look forward to working with you,

The Health Science Academy Faculty,
Mrs. Sally Couzens,  Mrs. Doreen Morris,  Mrs. Margueite Meyer

Email *
Student Information:
Full Name (Last name , First Name) *
Full Address (including town and zip code) *
Home Phone Number *
Student Cell Phone Number *
Period 1 Homeroom Number *
In 100 to 200 words, why do you want to join the Health Science Academy? *
Parent/Guardian Information:
Parent/Guardian Names *
Parent Cell Phone Number *
Parent Email Address: *
Apllicant's Activities and Community Service:
Please list all activities you are involved in at Hamburg High/Middle School. Include clubs, sport teams, music, etc.  After each, please list how long you have been involved in that activity and any leadership roles.  (Ex. Character Club - 1 year - Secretary) *
Please list any activities you are involved in outside of school. These could include scouting, dance, travel teams, church, etc. After each, please state how long you have been involved in that activity and any leadership roles. (Ex. Travel Volleyball - 2 years - Captain) *
Agreement & Signatures
By submitting this application, both the applicant and parent/guardian understand that the Academy is a three year curriculum and the applicant is expected to complete the entire program upon acceptance. I understand that the academy courses take precedence over other electives in the student's schedule. I affirm that the information set forth herein is true and accurate.
Students: Type your full name here. (A written signature will be required on the HSA contract if you are accepted.) *
Parents/Guardians: Type your full name here. (A written signature will be required on the HSA contract if your child is accepted.) *
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