NHIA: Online Application

*First Name:

Middle Name:

*Last Name:

Other names used for materials you intend to submit:

*Date of Birth:

*Male or Female:

Male
Female

Ethnicity (optional):

*Mailing Address:

Address Line 2:

*City

Province (if applicable):

*Zip Code:

*Home Telephone:

Other Telephone:

*Email:

*Applying for Semester:

Spring 2010
Fall 2010

*Will you be attending Full Time or Part Time?

Full Time
Part Time

*Are you interested in the Art Education Program?

Citizenship and Veteran Status

*Are you a U.S. Citizen?

*Are you a veteran?

Education

*High School 1:

*Dates Attended (mm/yyyy) From / To:

*Year Graduated:

High School 2:

Dates Attended (mm/yyyy) From / To:

Year Graduated:

College/University 1:

Dates Attended (mm/yyyy) From / To:

Year Graduated:

College/University 2:

Dates Attended (mm/yyyy) From / To:

Year Graduated:

Employment

*Are you employed?

If yes, where?

*Will you need housing to attend school?

Yes
No
Unsure

If other, please tell us:

If the institute was recommended to you by a past or present student or faculty member, please let us know who she/he is and if we may contact them to discuss your candidacy:

Name

Address:

Address Line 2:

City & State:

Province (if applicable):

Zip code:

Name:

Address:

Address Line 2:

City & State:

Guardian/Father's Province (if applicable):

Zip code:

*I _____ (check one) the New Hampshire Institute of Art permission to send press releases to my hometown newspaper concerning awards, shows, or other information about my work and accomplishment at the Institute which may be of interest to my family and

I give permission
I do not give permission

*THE INFORMATION I HAVE SUPPLIED ON THIS APPLICATION IS TRUE TO THE BEST OF MY KNOWLEDGE AND BELIEF. I UNDERSTAND THAT ANY MATERIAL SUBMITTED WITH THIS APPLICATION BECOMES PROPERTY OF THE INSTITUTE AND WILL NOT BE RELEASED TO ANOTHER PARTY WITHOUT MY PERMISSION.

When your application is complete, please fill in the word below and press submit. A thank you screen will appear following your submission. If this screen does not appear, please contact Admissions at 1-800-241-4918 with your contact information and someone will be in contact with you.

NIHA

Online Application

Citizenship and Veteran Status

Education

Employment

Admissions

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