Senator Evan Bayh — Senator for Indiana: Students

U.S. Senator Evan Bayh - Serving the People of Indiana

Academy Nomination Request Form

This form will assist you in requesting a nomination from Senator Bayh's office. Upon receiving your request, we will mail you an application packet. After you have completed this form, click "Create My Form" at the bottom of the page. Your information will be processed into a PDF document that you must then print and send to Senator Bayh's office. Please keep a copy of this form for your records.

Please enter your information in the fields below:

About You

Salutation
First Name*
Last Name*
E-mail*
Verify E-mail*
Phone Number*
Date of Birth
Place of Birth*
Social Security Number*
	I am a U.S. Citizen*
	By checking this box I certify that my Pre-candidate questionnaire has been sent to the Academy
Name of Parents/Guardians
Father's Daytime Phone Number:
Mother's Daytime Phone Number:
Extracurricular Activities:
	I am also applying to the following nominating sources (Representative/ Senator):

Choose an Academy

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

Permanent Address

Street Address*
Street Address (2)
City*
State
Zip Code*

Mailing Address

	same as permanent address.
Street Address*
Street Address (2)
City*
State
Zip Code*

High School Information

Name of High School*
Street Address*
Street Address (2)
City*
State
Zip Code*
Class Standing*	(e.g. 10 out of 1000)
GPA*
Graduation Date
Please Note: Creating this form will NOT send your application to Senator Bayh's office. You MUST print the PDF document that is generated by this form on the following page, sign, and send it to the Indianapolis office.

Return to Students // Academy Nominations // Form

Mail Delay

Please note that due to heightened security in the U.S. Capitol, mail service to the Washington, D.C. Senate office has been significantly delayed. If you have any correspondence that is time sensitive, please use alternatives such as e-mail, phone, or fax.

Academy Links

U.S. Air Force Academy

Admissions Office
HQ USAFA/RRS
2304 Cadet Dr.
Suite 200
USAF Academy, CO 80840-5025
www.usafa.edu

U.S. Military Academy

Director of Admissions
600 Thayer Rd.
West Point, NY 10996-9902
www.usma.edu

U.S. Naval Academy

Candidate Guidance Office
117 Decatur Rd.
Annapolis, MD 21402-5018
www.usna.edu

U.S. Merchant Marine Academy

Admissions Office
U.S. Merchant Marine Academy
Kings Point, NY 11024-9997
www.usmma.edu

U.S. Coast Guard Academy*

Director of Admissions
31 Mohegan Avenue
New London, CT 06320
www.cga.edu

*No congressional nominations to the U.S. Coast Guard Academy, contact CGA directly.

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Click on a location below for information

Washington, DC Capitol Building 131 Russell Senate Office Building
Washington, DC 20510
(202) 224-5623
(202) 228-1377 fax

1650 Market Tower
10 West Market Street
Indianapolis, IN 46204
(317) 554-0750
(317) 554-0760 fax

101 MLK, Jr. Blvd
Evansville, IN 47708
(812) 465-6500
(812) 465-6503 fax

1300 S. Harrison St.
Suite 3161
Fort Wayne, IN 46802
(260) 426-3151
(260) 420-0060 fax

Hammond 5400 Federal Plaza
Suite 3200
Hammond, IN 46320
(219) 852-2763
(219) 852-2787 fax

1201 E. 10th St.
Suite 106
Jeffersonville, IN 47130
(812) 218-2317
(812) 218-2370 fax

130 S. Main St.
Suite 110
South Bend, IN 46601
(574) 236-8302
(574) 236-8319 fax

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