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Student Interest Form

1Student

2Parent/ Guardian Information

3Program Pathway

4School Information

Student's Name*

First

Last
Student's Email*
Current Grade Level*
- 8
- 9
- 10
- 11
- 12

Parent/Guardian Name*

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Last
Parent/Guardian Cell Phone*
Parent/Guardian Address*

Street Address

Address Line 2

City

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ZIP / Postal Code

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Please enter the address, in which the student and parent reside.
Parent/Guardian's Email*

Select the CTE Program Pathway*
Area of Concentration Within Performing Arts*
How did you learn about Long Island High School for the Arts? (Check all that apply)*
- Website
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- My teacher
- I attended an Open House
- I attended One Plus One Day
- I attended the Summer Arts Academy at LIHSA
- Newspaper
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Name of Guidance Counselor

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Last
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239 Cold Spring Road
Syosset, NY 11791
(516) 622-5678

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The Long Island High School for the Arts is a program of Nassau BOCES.

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Our summer open house events have completed for the year. Please note our camps run onsite at LIHSA in partnership with Hofstra University. Please contact LIHSAOffice@nasboces.org or visit Hofstra Summer Camps for additional information. Summer scholarships are available for music and musical theatre for students in grades 7-11. Apply today.