Representative Madeleine Dean

Representing the 4th District of Pennsylvania

Military Academy Print Only Form

Fill out the form and click "Generate Application". Print the form and mail or fax to the address listed on the print page.

Your Information

* marks required fields of data.

This form requires you to print, sign and mail, fax, or hand deliver the signed document. Your social security number will not be transmitted electronically.

          
          
Contact Information

What are these options?
Constituents who are hard of hearing or use a video phone have the option to choose TDD or VP based on the type of device they are using. This allows our office to respond to them accordingly. The default option "Voice" is a standard audible telephone.

Education Information
Test Scores

SAT Scores

ACT Scores

Academy Information

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

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.

Additional Information

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 Application for Review" button below. The address information is located on this page and also on the print preview page.