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Military Academy Nominations Form

Thank you for your interest in the U.S. Service Academies. Please complete the form below.

* indicates required information

Contact Information

First Name: *

Middle Name:

Last Name: *

Date of Birth: *

Social Security Number:

Gender: *

Street Address: *

City: *

State *

Zip Code*

Telephone No.: *

U.S. Citizen: * Yes No If not, list your country of citizenship:

Parents/Guardians: *

Education Information

Name of High School: *

High School Street Address: *

City: *

State *

Zip Code *

GPA: *

Class Size

Rank

Graduation Date

Test Scores

SAT Scores

Math:

Writing:

Critical Reading:

Composite:

ACT Scores

English:

Math:

Reading:

Science:

Composite

Academy Information

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

U.S. Air Force Academy:

U.S. Merchant Marine Academy:

U.S. Military Academy (West Point):

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

NOTE: Please include a list of your extra curricular activities and leadership responsibilities.

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