Service Academy Nomination

Your Contact Information

Prefix First Name * First Name is required Last Name * Last Name is required Suffix Email Address * Email is required Invalid Email Address * Street is required City * City is required State * AL AK AZ AR CA CO CT DE DC FL GA HI ID IN IL IA KS KY LA ME MD MA MI MN MS MO MT NE NV NH NJ NM NY NC ND OH OK OR PA RI SC SD TN TX UT VT VA WA WV WI WY Zip Code * Zip is required Zip has to be a number Phone Number * Contact Phone Number is required Phone number must be 10 digits Date of Birth * Date of Birth is required Gender * Gender is required US Citizen *

Yes

No

Citizenship status is required Country of Citizenship

Parent/Guardian Information

Parent/Guardian Name * Parent/Guardian Name is required Address * Street is required City * City is required State * AL AK AZ AR CA CO CT DE DC FL GA HI ID IN IL IA KS KY LA ME MD MA MI MN MS MO MT NE NV NH NJ NM NY NC ND OH OK OR PA RI SC SD TN TX UT VT VA WA WV WI WY Zip Code * Zip is required Zip has to be a number

Education Information

High School Name * High School Name is required Address * Street is required City * City is required State * AL AK AZ AR CA CO CT DE DC FL GA HI ID IN IL IA KS KY LA ME MD MA MI MN MS MO MT NE NV NH NJ NM NY NC ND OH OK OR PA RI SC SD TN TX UT VT VA WA WV WI WY Zip Code * Zip is required Zip has to be a number GPA * High School GPA is required Class Size Rank Graduation Date

SAT Test Scores

Math Writing Critical Reading Composite

ACT Test Scores

English Math Reading Science Composite

Academy Information

First Pick U.S. Air Force Academy U.S. Military Academy U.S. Naval Academy U.S. Merchant Marine Academy Second Pick U.S. Air Force Academy U.S. Military Academy U.S. Naval Academy U.S. Merchant Marine Academy Third Pick U.S. Air Force Academy U.S. Military Academy U.S. Naval Academy U.S. Merchant Marine Academy Fourth Pick U.S. Air Force Academy U.S. Military Academy U.S. Naval Academy U.S. Merchant Marine 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

Extracurricular Activities Name of Hometown Newspaper Is it ok to use your name in a press release?

Yes

No