Congressman Jeb Hensarling

Representing the 5th District of Texas

Military Academy Nominations

Instructions

Thank you for your interest in the U.S. Service Academies. As your 5th District Representative in the U.S. House of Representatives, each year I have the privilege of nominating a limited number of people to four of the five service academies. The honor of attending a service academy comes with an obligation and commitment to serve in the military for a minimum of five years upon graduation. For more information, please review my page of Frequently Asked Questions for those seeking a Military Academy Nomination. Best wishes to you as you pursue your goal of attending one of the U.S. Service Academies and serving our country.

To the begin the Military Academy Nomination process with my office, please complete the form below. The completed form must be printed and mailed or faxed to my Dallas Office:

6510 Abrams Road
Dallas, TX 75231
Fax: (214) 349-0738

(PLEASE NOTE: The form below is not an application. It is merely a request for the application, which begins the nomination process.)

*indicates information that you need to provide.

Your Information

Prefix:

First Name:

MI:

Last Name:

Suffix:

Date of Birth:

Social Security Number:

Street Address:

Street Address Continued:

City:

State:

Zip Code:

Gender:

U.S. Citizen: Yes No

If not, list your country of citizenship:

Parents/Guardians:

Telephone

Telephone Number:

Education Information

Name of High School:

High School Street Address:

City:

State:

Zip Code:

GPA:

Class size

Rank

Graduation Date

Test Scores

SAT Scores

High School SAT Code: Find your code

Math:

Writing:

Critical Reading:

Composite:

ACT Scores

High School ACT Code: Find your code

English:

Math:

Reading:

Science:

Composite:

Academy Information

Number your preference (1 to 4) of academies — with 1 being your highest preference

U.S. Air Force Academy:

U.S. Merchant Marine Academy:

U.S. Military Academy (West Point):

U.S. Naval Academy:

An appointment to the Service Academies is based on a desire by the candidate to devote a lifetime of military service and implies recognition by the appointee of an obligation to the government to devote him / herself to a military career. Are you interested in an appointment on that basis?
Yes No

Additional Information

Name of hometown newspaper:

Is it okay to use your name in a press release after receiving a nomination or appointment?
Yes No

NOTE:

Please include a list of your extra curricular activities and leadership responsibilities.

Print This Form

You can print and sign this form after you click the Generate Form button. Completed forms should be mailed to my Dallas District Office (the address information is located on this page and also on the print preview page).

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Congressman Jeb Hensarling

Representing the 5th District of Texas

Military Academy Nominations

Instructions

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Military Academy Nominations

Instructions

NOTE:

Print This Form

Athens District Office

Dallas District Office

Washington, DC Office