Response

Congresswoman Mary Miller
15th Congressional District of Illinois

3236 Broadway St, Suite 200
Quincy, IL 62301

Phone: (217) 640-6210

Class of 2029 Academy Application

PRIVACY ACT STATEMENT: Submission of the requested information constitutes authorization to release it to Congresswoman Miller, her academy advisory committee, and the academy admissions offices.

DEADLINE FOR SUBMISSION: Friday, NOVEMBER 22, 2024 at 5:00 PM CST
**You must reside in the 15th Congressional District to receive this nomination**

Materials need to be mailed or hand delivered to our Quincy District Office (3236 Broadway St, Suite 200, Quincy, IL 62301) by November 22, 2024 5:00 PM CST are:

* 3 letters of recommendations (for example, teachers, employers, pastor, advisors, other)

* Sealed High School Transcripts and Sealed College Transcripts (If Applicable).

PERSONAL INFORMATION:

First Name

Last Name

Address Line 1

City

State

Zip

Cell Phone

Home Phone

Confirm Email

Mailing Address, if different from home address:

Date of birth:

Gender:

Height: (feet & inches)

Weight: (lbs.)

Did you pass the Candidate Fitness Assessment?

What was your Candidate Fitness Assessment score?

Is your corrected visual acuity in each eye at least 20/20?

Are you a U.S. Citizen?

Academy Preferences:

(Rank academies, for which you submitted an application, 1-4 according to your reference. If not applying there, leave blank)

United States Air Force Academy

United States Merchant Marine Academy

United States Military Academy (West Point)

United States Naval Academy

Other applications for nomination you have applied for (please check all that apply):

Tammy Duckworth

Dick Durbin

Vice President

Other

If "Other" was selected input name of elected official here

FAMILY INFORMATION:

Father's Contact Information:

First Name

Last Name

Address Line 1

City

State

Zip

Confirm Email

Phone

Cell Phone

Father's Occupation:

Mother's Contact Information:

First Name

Last Name

Address Line 1

City

State

Zip

Confirm Email

Phone

Cell Phone

Mother's Occupation:

Legal Guardian:

Legal Guardian Phone:

Legal Guardian Email:

Are you on active duty or in a reserve component of the armed forces?

If yes, which service?

Do you have any dependents (children or spouse)?

EDUCATIONAL INFORMATION:

High School:

High School Full Address:

High School Phone Number:

Date of Graduation:

Grade Point Average/Scale: (e.g. 4.5/4.0 or 4.5/5.0)

Class Ranking: _______ of _______

COLLEGE/ PREPARATORY SCHOOL:

College/Preparatory School:

College/Preparatory Address:

Major:

Credit Hours Earned:

Grade Point Average/ Scale:

Date of Graduation:

Digital Headshot Photo

Insert Digital Headshot Photo of Yourself Here: (10MB max. file size. High Res. File type = .jpg .png .tiff or .gif)

Upload FileNo file chosen

Essay

ESSAY--Why I want to attend a Service Academy (200 words)

Upload Essay Here: (File types supported 10MB max. File types supported .doc. docx .pdf .txt)

Upload FileNo file chosen

SAT/ACT

COLLEGE ENTRANCE EXAMINATIONS:
For an application to be considered complete, applicants are required to have taken the SAT or ACT at least once, prior to the application deadline of Friday, NOVEMBER 22, 2024.

Upload SAT/ACT Scores Here:

(SAT or ACT scores scanned and image uploaded. File types supported 10MB max. file size. High Res. File type = .jpg .png .tiff .gif or .pdf)

Upload FileNo file chosen

Apply BOTH the Applicant AND Parent/Legal Guardian Signatures just below.

Input Today's Date

PLEASE READ BEFORE SIGNING:

I have read and understand the information provided in this application regarding the nominating process. I affirm that I have never been convicted or arrested for violating a state or federal statute. I understand the deadline for my application is November 22, 2024 at 5:00 PM CST. If I have not submitted all of the required information by the deadline, I understand that my application will be considered incomplete. I have answered all questions truthfully and to the best of my knowledge. I understand that any false information could result in me not getting a nomination. I also understand that filling out an application does not guarantee me a nomination, and a nomination does not guarantee an offer of admission to an academy. I also give permission for my name to be released to the media in the event that I am nominated by Congresswoman Mary Miller.

Signature (Print Name):

Date Signed:

Signature of Parent/Guardian (Print Name)

Date Signed: