Response

U.S. Congressman Darin LaHood
Service Academy Nomination Application

*This application is for the Class of 2029*

Please indicate your academy preference ("1" being your first choice and "4" being your last):

West Point

Air Force Academy

Naval Academy

Merchant Marine

Are you applying to the two US Senators from Illinois? Yes or No

If you need assistance locating the Senators' offices, please contact Congressman LaHood's office.

Personal Information

First Name

Last Name

Home Address

City

State

Zip

Confirm Email

Cell Phone

Home Phone

Social Security Number:

Date of Birth:

Parents' Names and Phone Numbers (Home & Cell)

Father's Home Phone

Father's Cell Phone

Mother's Name:

Mother's Home Phone:

Mother's Cell Phone:

High School / College Information

Name of your High School:

High School Counselor's Name:

Counselor's Phone Number and/or Email:

Year of Graduation:

Class Ranking: Number___of_____

H.S. GPA: ___/___

Your best ACT Scores:

Your best SAT Scores:

If you have already graduated high school, please list all of the colleges you have attended, and their addresses:

Current College GPA: ___/____

Medical Information

Do you wear glasses or contacts? Yes or No

What is your range of vision (20/20, etc.)?

Right Eye

Do you have any medical conditions that may require special consideration by the Academy, or a medical waiver (asthma, an orthopedic injury, etc.)? If so, please explain:

*If you are unsure if a medial waiver is needed, please ask your academy liaison officer ASAP*

If you have not already, you must contact the Academy(s) of your choice and apply. Their application process is in addition to the congressional nomination process.

Information on how to contact the various academies can be found on Congressman LaHood's website at https://lahood.house.gov/

Please include a separate sheet (resume format) for the athletic participation and extracurricular activities below:

Athletic Participation

Please list all sports with which you have been involved, the number of years you have participated, if you have lettered in that sport, and if you have received any related honors.

Resume format for Athletic Participation: (15mb limit, files types supported--.doc, .docx, .pdf & .txt)

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Extracurricular Activities

Please list all memberships and leadership positions in clubs and organizations such as FFA, Scouts, 4-H, National Honor Society, etc. Also list any involvement in student government or other school activities, including JROTC, community service, and church-related activities. Include any honors you have received in relation to these activities.

Resume format for Extracurricular Activities: (15mb limit, files types supported--.doc, .docx, .pdf & .txt)

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Employment

Are you employed? Yes or No

If yes, how many hours per week?

What type of work?

If your employment is limiting your participation in sports and other activities, please explain:

Application Packet Checklist

Before submitting your application, please review the required checklist below:

✓ Essay explaining why you wish to attend a service academy *No less than 150 words* (attach)

✓ Resume of athletic participation and
extracurricular activities (attach)

✓ Most recent high school transcript (attach)
*Please include college transcript, if applicable

✓ ACT and SAT exam scores (attach)

✓ Current photo (attach)

✓ At least four letters of recommendation (attach)
From: teachers, counselors, employers, coaches...

*Letters should include a return address, phone number and email*

Attach Essay here:

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Attach 4 Recommendation Letters here:

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Upload Current photo here:

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Upload ACT and SAT exam scores here:

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PLEASE READ CAREFULLY BEFORE SIGNING

I give Congressman Darin LaHood's office consent to use my name in a press release announcing his nominations to the service academies as well as a press release announcing nominated applicants who receive offers from the service academies and/or nominated applicants who accept appointments to the service academies. I understand that a nomination by the Congressman does not constitute acceptance to an academy and that I must undergo the entirety of the application process to receive an offer.

I have read the information contained in this e-packet explaining the nomination process of Congressman LaHood. I understand the Congressman's requirements. All requirements must be met or an interview will not be granted. I am also aware of the application deadline of 5pm, November 15th, 2024. I certify that I am a legal resident of the Sixteenth Congressional District of Illinois. There is no known reason I should not be medically qualified to receive an appointment to a service academy, if nominated. In signing this form, you are stating that you understand the nomination requirements for the Office of U.S. Congressman Darin LaHood and that you will abide by these requirements.

By checking this box. I agree to the above statements

Today's Date:

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