HSSA - Student Indication of Interest Form : Education : Nebraska Wildlife Rehab, Inc.

APPLICATIONS DUE MAY 25th, 2026.

Please complete and submit the form below for application to High School Science Academy. Take your time and answer each question completely and thoughtfully with multiple sentences. NO NOT use AI to generate your answers. AI submissions will not be accepted.

This program has limited space and the process is competitive -- the more thoughtful your application, the more we'll be able to understand why you will benefit from this program.

First & Last Name

Preferred Pronouns

High School

Grade Level in *26-27* School Year:

(Schools often block my emails, I also want to get in touch with you over the summer)

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NON-SCHOOL RELATED Email

Email:

Phone Number

Referring Teacher or Mentor

(Ensure they fill out the referral form by due date or application will not be considered)

Why do you want to participate in this program? (Please be thorough.)

What science classes have you taken and how have they formed or changed your interest in science?

How have you demonstrated your interest in science in and outside of school?

What do you expect to do after high school?

Education

HSSA - Student Indication of Interest Form

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