NLA Application

The application will take about 15-20 minutes to complete. You must complete every question with an *, including the 5 short-answer questions at the end. We look forward to reviewing your application!

Applicant Personal information
Student Name *
Student Name
Birthdate *
Birthdate
Gender *
Have you attended NLA before?
Check the box to register for the Y2 Program
I am sponsored by:
If you are receiving a sponsorship, please select the sponsoring organization.
Applicant's school information
Student Contact Information
Home Address *
Home Address
Student Phone *
Student Phone
Parent/Guardian Information (multiple optional)
Parent/Guardian #1 Name *
Parent/Guardian #1 Name
Parent Phone *
Parent Phone
Parent/Guardian #2 Name (Optional)
Parent/Guardian #2 Name (Optional)
Parent Phone
Parent Phone
Recommendation
Provide the name and email address of a teacher, employer, coach or school counselor that will recommend you for our program.
Recommendation Name *
Recommendation Name
General Information
How did you hear about NLA? *
Please let us know where you found us
Please let us know who to Thank for referring you!
we want to get to know you!
Short answer section