Military Academy Nominations Form Your Information Prefix —Please choose an option—Mr.Ms.Mrs.MissMr. and Mrs.Dr. First Name * Last Name * Date of Birth * Street Address * Street Address (2) City * State * IdahoArizonaAlabamaAlaskaArkansasMassachusettsCaliforniaColoradoConnecticutDelawareWashington DCFloridaGeorgiaHawaiiIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVirginiaVermontWashingtonWest VirginiaWisconsinWyoming Zip Code * Gender * MaleFemale U.S. Citizen? * YesNo If not, list your country of citizenship Parents/Guardians * Phone * Email * Education information Name of High School * High School Address * City * State * IdahoArizonaAlabamaAlaskaArkansasMassachusettsCaliforniaColoradoConnecticutDelawareWashington DCFloridaGeorgiaHawaiiIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVirginiaVermontWashingtonWest VirginiaWisconsinWyoming Zip Code * GPA * Class Size Rank Graduation Date Test Scores SAT Math Writing Critical Reading Composite ACT Math English Reading Science Composite Academy Information Number your preference (1 to 4) of academies — with 1 being your highest preference. U.S. Air Force Academy * —Please choose an option—1234 U.S. Merchant Marine Academy * —Please choose an option—1234 U.S. Military Academy * —Please choose an option—1234 U.S. Naval Academy * —Please choose an option—1234 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? * YesNo Additional Information Name of "hometown" Newspaper * Is it okay to use your name in a press release after receiving a nomination or appointment? * YesNo Please list your extra curricular activities and leadership responsibilities. *
