Military Academy Nominations

Instructions

Thank you for your interest in the U.S. Service Academies. As your 7th District 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. For more information, please review my page of Frequently Asked Questions for those seeking a Military Academy Nomination. To request a Military Academy Nomination packet my office, please complete the form below. Completed packets must be submitted no later than 5 p.m., Friday, October 19th, 2012.

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

* indicates information that you need to provide.

Academy InformationAcademy or academies for which you wish to be considered (in order of preference):
 
 
Have you requested a pre-candidate file at any of these academies?
 
 
Have you submitted a pre-candidate questionnaire at any of the academies?
 
 
Have you applied to Wisconsin's two U.S. senators or the Vice President of the United States?
 


Personal Information
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Do you wear glasses?*
Do you wear contacts?*
 
 
U.S. Citizen: *
 
Are you a 7th District resident: *
Have you ever been arrested?
 
 

*An arrest will not necessarily bar your nomination. The Academy Nomination Commission will take disposition, seriousness and nature of the violation into account.
 
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Education Information
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Have you taken your ACT exam?*
 
Have you taken your SAT exam?*
 
*You do not need to take both tests, but you must provide official copies of either your SAT or ACT scores. If you have already taken either examination, you should contact the College Entrance Examination Board for SAT scores, or ACT for ACT scores and request that a copy of your scores be sent directly to Congressional Code 7760 for ACT and Congressional Code  0265 for SAT. If you have not yet taken these examinations, please list these codes as one of the recipients of your scores at that time.>
Have you ever been disciplined by your school administration for any reason in the last two years?*
 
If yes, please explain?


Additional Information
In 300 words or less, explain your reasons for wanting to attend a military service academy.
List school and/or community activities you are involved in including duration and hours per week.

List any awards or honors you have received.

List any job experience including duration and hours per week.

*If you feel there are special conditions or circumstances regarding your application that we should take
into consideration, please elaborate briefly (e.g. extremely difficult course load, a traumatic event that affected
your performance, etc.).


 

Print This Form

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.


 

Any questions regarding this application should be directed to Jocelyn Berkhahn, Director of Constituent Services, at (715) 298-9344.