Service Academy Nominations
Prefix
First Name
MI
Last Name
Suffix
Address Line 1
Address Line 2
City
State
Alabama
Alaska
America Samoa
Arizona
Arkansas
California
Colorado
Connecticut
D.C.
D.C.
Delaware
Federated States of Micronesia
Florida
Foreign Correspondence
Georgia
Guam
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Marshall Islands
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Northern Mariana Islands
Ohio
Oklahoma
Oregon
Palau
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Trust Territory
Utah
Vermont
Virgin Islands
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Zip
Email
Phone
Birth Date
County of Residence
Sex
Male
Female
Please list your Parent/Guardian Names
Please list any relatives who were/are service members.
School Information
Graduation Date
Graduation Rank
GPA
Indicate all other sources you have contacted regarding a nomination. You should contact all available resources.
U.S. Senator Elizabeth Warren
U.S. Senator Edward Markey
Vice President Kamala Harris
If none of the above please list any other sources
SAT Test Score - Verbal
SAT Test Score - Math
Which academies are you applying to?
USNA
USAFA
US Military Academy (West Point)
Merchant Marine Academy
Please list three people who will write a recommendation on your behalf. Transcripts/letters of recommendation can be attached directly to this form, emailed to joseph.weydt@mail.house.gov or mailed to the Boston office:
Office of Congressman Stephen F. Lynch
1 Harbor Street, Suite 304
Boston, MA 02210
Please list any extra curricular activities (sports, clubs, etc.).
Please include an essay outlining why you want to attend a service academy.
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