Service Academy Application

Name:
Prefix * First Name * MI Last Name * Suffix
* Address:
* City: * Zip:
Home Phone Number:
Cell Phone Number:
* Email:
Present Address (If different from Above):
How Long Have You Been A Resident of Idaho?
Are Your Parents Legal Residents of Idaho? Yes No
Personal Info:
Birthday Age Height Weight
SSN (No Dashes):



Father's Info:
Name:
Address
City State Zip


Mother's Info:
Name:
Address
City State Zip



Are you are currently enlisted or have previous military service? Yes No
Is either of your parents career military personnel? Yes No
If yes, state branch, rank, and length of service


Education Info: List high schools, prep schools, and colleges you have attended/are now attending.
High School Graduation Date
College Graduation Date


Academy Preference: Indicate your preference in numerical order. Please do not designate any academy you would not accept. Due to the competitive nature of the nomination process, you may receive a nomination to the academy of your second, third, or fourth choice.
First Second
Third Fourth






Have you opened a pre-candidate file the academy (academies) you listed? Yes No
If yes, which ones?
If no, you must contact the academies as soon as possible as your request for nomination will not be considered if you fail to open a candidate file with the academy (academies).


Have you applied to the United States Coast Guard Academy?
Yes No
Have you applied for the ROTC? Yes No
Have you applied to the following nominating authorities? Senator James E. Risch Senator Mike Crapo
Vice President Joe Biden


EXTRACURRICULAR ACTIVITES
Remember to include:
  • Special awards and honors with dates.
  • School and outside club memberships and activities, noting leadership positions and honors received, with dates.
  • Employment, both after school and in summer, with dates and hours per week.
  • Volunteer involvement, with dates and hours per week.
  • School athletics (note Captain, Varsity letter, MVP, All-League, etc.) with dates.
  • Out-of-school recreational athletics, with dates.
Is it ok to use your name in a press release? Yes No
Name of home town paper?
The information above is correct. I am an U.S. Citizen or will be by July 1, 2016; am at least 17 but not 23 years of age on July 1, 2016; am unmarried, not pregnant; have no child support obligation; and am a legal resident of the State of Idaho.
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