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Academy Nomination (Print)

Thank you for your interest in the U.S. Service Academies.

As your 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.

Best wishes to you as you pursue your goal of attending one of the U.S. Service Academies and serving our country.

To request a Military Academy Nomination form my office, please complete the form below.

* indicates required field.

Your Information

Prefix:

First Name:*

MI:

Last Name:*

Suffix:

Street Address:*

Street Address Continued:

City:*

State:*

Zip Code:*

+4 Extension:

Date of Birth:*

Social Security Number:

U.S. Citizen:* Yes No

Gender:* Male Female

Place of Birth:

Parents/Guardians:

Contact Information

Email:*

Cell Phone:*

Evening Phone:

Temporary Address

Street Address:

Street Address Continued:

City:

State:

Zip Code:

+4 Extension:

Education Information

High School Name & Address:

Graduation Date:

GPA:

Class Rank:

Class Size:

College you are attending:

SAT Test Scores

Math:

Writing:

Critical Reading:

Composite:

ACT Test Scores

Math:

Writing:

Reading:

Science:

Composite:

Academy Information

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

Air Force:

Merchant Marine:

Military (West Point):

Naval:

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

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

You can print and sign this form after you click the Generate Form button. The address information is located on this page and also on the print preview page.

HIDDEN_WEBSITE_VARIABLES

How to use: Insert <span class="EXACT_VALUE_LABEL_AS_ENTERED_BELOW"> </span> where you'd like the value to be populated.

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Label (no spaces or special characters)	Value	Comments (optional)
repName	Congressman Mark Amodei
helpWithFedAgencyAddress	332 Cannon House Office Building Washington, DC 20515
district	2nd District of Nevada
academyUSCitizenDate	July 1, 2016
academyAgeDate	July 1, 2016
academyApplicationDueDate	October 20, 2016
repStateABBR	NV
repDistrict	2
repState	Nevada
repDistrictText	2nd
repPhoto
SponsoredBills	Sponsored Bills
CoSponsoredBills	Co-Sponsored Bills

Office Locations

Office Name	Location	Image	Map URL
Reno Office	5310 Kietzke Lane, Suite 103 Reno, NV 89511 Phone: (775) 686-5760 Fax: (775) 686-5711		https://goo.gl/maps/q79GzGLXCfD2
Washington Office	332 Cannon House Office Building Washington, DC 20515 Phone: (202) 225-6155 Fax: (202) 225-5679		https://goo.gl/maps/LHerJswiK862
Elko Office	905 Railroad Street, Suite 104 D Elko, NV 89801 Office: (775) 777-7705 Fax: (775) 753-9984		https://goo.gl/maps/q79GzGLXCfD2