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Service Academy Nomination
Required fields are followed by
*
.
Contact Information
Prefix:
*
First Name:
*
Last Name:
*
Suffix:
Email Address:
*
Street Address:
*
Street Address: (Continued)
City:
*
State:
*
AL
AK
AZ
AR
CA
CO
CT
DE
DC
FL
GA
HI
ID
IL
IN
IA
KS
KY
LA
ME
MD
MA
MI
MN
MS
MO
MT
NE
NV
NH
NJ
NM
NY
NC
ND
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VT
VA
WA
WV
WI
WY
AA
AE
AP
FM
GU
MH
MP
PR
VI
AS
Zip Code:
*
Phone Number:
*
Date of Birth:
*
Gender:
*
U.S. Citizen?
*
Yes
No
Country of Citizenship:
Parent/Guardian Information
Names of Parents/Guardians:
*
Street Address:
*
City:
*
State:
*
AL
AK
AZ
AR
CA
CO
CT
DE
DC
FL
GA
HI
ID
IN
IL
IA
KS
KY
LA
ME
MD
MA
MI
MN
MS
MO
MT
NE
NV
NH
NJ
NM
NY
NC
ND
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VT
VA
WA
WV
WI
WY
AA
AE
AP
FM
GU
MH
MP
PR
VI
AS
Zip Code:
*
Education Information
High School Name:
*
High School Address:
*
City:
*
State:
*
AL
AK
AZ
AR
CA
CO
CT
DE
DC
FL
GA
HI
ID
IN
IL
IA
KS
KY
LA
ME
MD
MA
MI
MN
MS
MO
MT
NE
NV
NH
NJ
NM
NY
NC
ND
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VT
VA
WA
WV
WI
WY
AA
AE
AP
FM
GU
MH
MP
PR
VI
AS
Zip Code:
*
GPA:
*
Class Size:
Class Rank:
Graduation Date
*
:
Extracurricular Activities:
SAT Test Scores
Math:
Writing:
Critical Reading:
Composite:
ACT Test Scores
Math:
English:
Reading:
Science:
Composite:
Academy Information
First Pick:
--- Please Select One ---
U.S. Air Force Academy
U.S. Military Academy (West Point)
U.S. Naval Academy
U.S. Merchant Marine Academy
Second Pick:
--- Please Select One ---
U.S. Air Force Academy
U.S. Military Academy (West Point)
U.S. Naval Academy
U.S. Merchant Marine 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
Answer one question with a maximum of 500 words
1) Everybody faces setbacks or failures. Discuss an instance when you faced a significant challenge or setback. What did you learn from it, and how has it influenced your principles and actions?
2) Share an instance where you chose to act with integrity even when it was not the easiest or most convenient path. How did this choice impact you and those around you?
3) Ethics and honesty are often tested in various life situations. Can you provide an example of a time when you had to make a decision that put your integrity to the test?
Answer one question with a maximum of 500 words
1) Discuss a time when you had to adapt to a significant change or overcome a challenging situation. How did your actions reflect your commitment to integrity and excellence?
2) Recall a situation where you felt a deep sense of responsibility towards a task or mission. How did you handle it and what was the outcome?
3) How have you shown dedication to improving your community, whether it be your school, local area, or the broader society? Share an example of your engagement or leadership in a public service role. 4) Share an experience where you put the needs of others before your own? How did you feel and what impact did your actions have?
Answer one question with a maximum of 500 words
1) Describe an instance when you contributed to a team effort. How did your commitment to service and excellence influence your role in the team and the final outcome?
2) Describe a situation where you went above and beyond to achieve excellence. What drove you to pursue such high standards and what was the outcome?
3) Describe a time when you took on a leadership role. What challenges did you face, and how did you address them? What were your key takeaways from this experience?
Answer one question with a maximum of 500 words
1) Describe a time when you had to take a stand for something you believed was right, even if it was unpopular or challenging. What motivated your decision and what were the consequences?
2) Recall a situation where your dedication to a cause or task was severely tested. How did you demonstrate resilience, and what was the outcome?
3) Describe a significant obstacle or failure you've experienced. How did you handle it, and how has this experience influenced your moral, mental, and physical development?
Name of Hometown Newspaper:
Is it ok to use your name in a press release after receiving an appointment?
Yes
No
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