Academy Request Form

The Service Academy Nomination Application cannot be saved and completed later. Please make sure you have all necessary materials before you start the application. You may only submit one application. If more than one is submitted, we will use the first application. You will have until midnight on September 4, 2019 to complete and submit your application.

2019 Service Academy Nomination Application

Note: Fields marked with an * are required.

Personal Information

First Name *

Middle Name

Last Name *

Name you are known by, if different from your first name

Month of birth *

Day *

Year *

Gender *

Mailing Address

Address *

City *

State *

Zip Code *

Permanent Address

Same as mailing address

Address

City

State

Zip Code

Contact Information

Email Address *

Best phone number to contact YOU *

(such as your personal cell phone)

Name of parent(s) or guardian(s) *

Parent or guardian's phone number *

Have you requested nomination before? *

Yes

Are you requesting a nomination for other members of the delegation? If so, who?

Florida County of Residence *

United States Congressman that represents your home district *

Academic Information

List each high school you have attended *

(in order of attendance)

Date of high school graduation? *

Name of guidance counselor *

Phone number for guidance counselor *

Address of high school you expect to complete. *

City *

State *

Zip code *

GPA *

GPA Weighted or Unweighted *

Class Rank *

(indicate if your school does not rank students)

Number of students in your graduation class *

Enrollment status as of September 1, 2018 *

If a high school graduate, please tell us your status

What are you currently doing.

Academic, Athletic, and Extracurricular Involvements

School Organizations

List all academic and extracurricular school-affiliated organizations in which you participated in high school. Include the years you participated in the organization and leadership positions you may have held. Do not use abbreviations; list full name of each organization.

Athletic Participation

List all athletic involvement, the number of years you participated and leadership positions you may held on the team.

Awards and Honors

List awards and honors you received and the year in which it was received.

Work Experience

List and briefly describe your work experience.

Volunteer Experience

List and briefly describe your involvement in volunteering.

Community Clubs and Organizations

List and briefly describe your involvement in community organizations.

Academy Leadership Seminar

If you have attended an Academy Leadership Seminar, list which one.

Academy Preference

This Application is for you to be considered at the four United States Service Academies: The Air Force Academy, Merchant Marine Academy, Military Academy/West Point, and the Naval Academy. Please order according to preference. You will be considered only for those academies for which you have indicated an interest and in the order you have ranked them below.

First Choice *

Second Choice

Third Choice

Fourth Choice

Other Information

Have you ever been found responsible for a disciplinary violation at any secondary school you have attended, whether related to academic misconduct or behavorial misconduct, that resulted in your suspension, removal, dismissal, or expulsion from the institution? *

Have you ever been convicted of a felony? *

If you responded yes to either of the previous two questions, please explain.

Personal Responses

Please answer the following questions. Each response should be 5,000 characters or less.

*Responses exceeding the 5,000 character limit will not be submitted successfully

Why do you want to attend a Service Academy? *

What characteristics do you possess that would enable you to excel in a Service Academy? *

Do you plan to pursue a career in military service? *

Have you overcome an obstacle that demonstrates your leadership abilities? If so, please describe. *

What military leader, either current or historic, do you admire and why? *

Please limit your response to one military leader.

Why should you be considered as a leader of character? *