Full name: ________________________________________ |
Name of parent/guardian: ____________________________ |
Permanent address:
_____________________________________________________
City: ______________________ State :_______ Zip:_________ |
Temporary address (if different): _____________________________________________________
City: ______________________ State :_______ Zip:_________ |
Home Number: __________________ Mobile :_______________ |
Social security number: ______________ Date of birth: ___________ |
Please circle one: Male / Female |
High school & year of graduation: ___________ |
Academy preference (Please rank 1-4 and only mark academies you are applying too):
Air force _____ Merchant Marine _____ Military ______ Navy ______ |
I have taken/will take the SAT or ACT on:_______________ |
SAT/ACT scores (SAT code: 0227/ACT code: 7193) ___________ GPA:__________ |
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I will ask the following persons for letters of recommendation:
1. _____________________________________________________________________
2. _____________________________________________________________________
3. _____________________________________________________________________ |
I am also seeking a nomination through: |
I am a citizen of the United States, or I will have attained citizenship before I enter the Academy. I am a legal resident of the State of Washington . I understand I must submit all necessary information by December 31st, 2008 to be considered for a nomination by Senator Maria Cantwell.
Signature __________________________ |