Extreme Makeover Entry Form

Company
This field is for validation purposes and should be left unchanged.
Entries will be accepted Monday, June 8 – Wednesday, July 1, 2026

Entries received after 11:59 AM CDT, Wednesday, July 9, 2025 will not be accepted

Official Rules
Name*
First Last
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Daytime Phone
Evening Phone
Email*
Birth Date*
Month
Day
Year
Have you ever attended NIACC in the past?
- Yes
- No
How did you hear about the contest?*
Please list how you heard about the contest*
Tell us about your current employment/life situation.*
What have you gained from your life or work experiences that would help you successfully complete an education at NIACC?*
What are your educational and career goals?*
How would winning Extreme Makeover change your life?*
Why should you be the winner of the NIACC Extreme Makeover?*
Upload photo
Accepted file types: jpg, gif, png, jpeg, webp, Max. file size: 10 MB.
Agreement*
- If I am selected as an Extreme Makeover recipient, I give NIACC permission to use my photo, name, and story in announcements, social media, advertising, and other marketing materials.
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