Military Academy Nominations

Instructions

Thank you for your interest in the U.S. Service Academies. As your 1st District Representative in the U.S. House of Representatives, I have the privilege of nominating candidates to four of the five service academies. If you would like to receive an application packet, please complete the following form or contact Joyce Fleming in my District Office at (503) 469-6010. For more information, please read our FAQ.

PLEASE NOTE: WE WILL BEGIN ACCEPTING APPLICATIONS FOR NOMINATIONS TO U.S. SERVICE ACADEMIES FOR THE 2016-2017 SCHOOL YEAR IN MAY 2016.

* indicates information that you need to provide.

Your Information

First Name: *

Middle Name:

Last Name: *

Date of Birth: *

Street Address: *

City: *

State: *

Zip Code: *

Gender: *

U.S. Citizen: *
Yes No

If not, list your country of citizenship:

Telephone

Telephone Number: *

Voice

TTD

Education Information

Name of High School: *

High School Street Address: *

City: *

State: *

Zip Code: *

GPA: *

Class Size

Rank

Graduation Date

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:

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

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Military Academy Nominations

Instructions

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