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Service Academy Nominations

Please fill out the below form to submit your application. If you have not read our info on service academy nominations, please click here prior to filling out the form.

Motivation
In addition to the information provided, describe why you wish to attend a service academy. 500 words or less: *
Additional Considerations
If you feel that there are special conditions or circumstances that we should take into consideration, please elaborate briefly (e.g. an extremely difficult course load, a critical event that affected your performance). 500 words or less.
Contact Information

Fill out all information completely. Any missing information may adversely affect your chances for nomination.

Prefix *
First Name *
Last Name *
Date of Birth: *
Place of Birth: *
City:

State:
Gender: *

Permanent Mailing Address: *

Street Address: *
City: *
State: *
Zip Code: *
Email Address: *
Primary Phone Number: *
Are you a U.S. Citizen? *
Yes No
Are you a TX-16 Resident? *
Yes No
If no, please state connection or home of record: *
Month and year for which you are requesting a nomination: *
Month:

Year:
Are you a high school graduate between the ages of 17 and 22, unmarried, have no dependents, and of high moral character? *
Yes No
Parent/Guardian Information
Names of Parents/Guardians: *
Street Address: *
City: *
State: *
Zip Code: *
Academy Interest
Which of the academies are you interested in attending? Please number according to your preference. You will be considered only for those academies for which you have indicated an interest, and in the order in which you have ranked them below (1st, 2nd, 3rd, 4th). *
First
Second
Third

Fourth
Have you requested that a pre-candidate file be initiated for you at any of the academies? *
If yes, which one(s)?
Have you been contacted by a Service Academy Representative? *
If Yes, by whom and which Academy?
Education History and Accomplishments
High School Name: *
High School Address: *
City: *
State: *
Zip Code: *
GPA: *
Principal:
Counselor:
Class Size:
Class Rank:
Graduation Date:
Test Scores

Advanced Placement (AP) or International Baccalaureate (IB) Classes taken with test scores (If Applicable):
Please add any additional information the review board might consider relating to your transcript, test scores, or class load:
Names and Addresses of all High Schools and/or Colleges Attended (If Applicable):
AWARDS AND HONORS (be specific):
School Related Extracurricular Activities
Please indicate years of participation after each activity. (1yr=Freshman, 2yrs=Sophomore, 3yrs=Junior, 4yrs=Senior):
Have you been in contact with any athletic staff or coaches from any Service Academy?
COMMUNITY ACTIVITIES (please indicate duration and hours per week):
WORK EXPERIENCE (please indicate duration and hours per week):
MILITARY EXPERIENCE (e.g. JROTC or Civil Air Patrol):


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