Service Academy Nominations Print Only

Service Academy Nominations Print Only

Note: Fields marked with an * are required.

Prefix *

Ms. Miss. Mrs. Mr. Mr. and Mrs. Rev. Dr. The Honorable Rabbi

First Name *

Middle

Last Name *

Suffix

2nd 3rd 4th II III IV Jr. Sr. M.D. PH.D. and Family

Birth Date *

Street Address *

Street Address Continued

City *

State *

Zip Code *

Social Security Number

For security reasons the social security number field must be filled out by hand.

Email *

Cell Phone Number *

Home Phone Number *

Gender *

Male Female

Parent / Guardian Name *

Are you a United States Citizen? *

Yes

No

If not, list your country of citizenship

School Information

School Name *

School Address *

City *

State *

Zip Code *

Graduation Date *

Graduation Rank *

Class Size *

GPA *

SAT Test Scores

Reading

Writing

Composite

Math

ACT Test Scores

Math

English

Reading

Science

Composite

Academy Information

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

First Choice *

U.S. Merchant Marine Academy U.S. Military Academy U.S. Naval Academy U.S. Air Force Academy

Second Choice *

U.S. Naval Academy U.S. Military Academy U.S. Merchant Marine Academy U.S. Air Force Academy

Third Choice *

U.S. Military Academy U.S. Air Force Academy U.S. Merchant Marine Academy U.S. Naval Academy

Fourth Choice *

U.S. Military Academy U.S. Air Force Academy U.S. Merchant Marine Academy 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