Application for Congressional Nomination to U.S. Service Academies

Note: Fields marked with an * are required.

Personal Information

Permanent Address

Mailing Address (if different than permanent address)

Other Details

U.S. Citizen

Do you wear glasses?

Do you wear contact lenses?

Uncorrected Vision

Corrected Vision

High School

Test Scores

(College or Scholarship Program Code: SAT 2754 ; ACT 7649)

SAT

ACT

College

Parents/Guardians

Parents or Guardians?

Father

Was your father a career military officer?

Is he retired?

Mother

Was your mother a career military officer?

Is she retired?

Other Family

Employment

Have you ever been employed?

(Employer, Position/Title, Dates of Employment)

Extracurriculars

Organization, Office Held/Awards Earned, Class Year of Participation

Type, Position, Letters/Awards, Class Yr of Participation

Award/Honor, Organization, Date

Other Questions

Letters must be received in the office prior to interview

Top 5 schools (include U.S. service academies, ROTC programs, colleges and universities) where you are an official candidate (Pre-Applications NOT Included)

Please note: IT IS UP TO EACH APPLICANT TO ALSO CONTACT EACH ACADEMY ON THEIR OWN.

Will you accept an offer to an academy prep school?

Are you applying to more than one service academy?

Will you accept an offer to your secondary choice?

Are you a recruited athlete?

Have you applied for a nomination to the vice president and/or your United States senators?

Have you been in contact with an academy liaison officer?

Checklist

  1. Application
  2. Signed Certificate (next page)
  3. 3 Letters of Recommendation
  4. Personal Essay
  5. Photo (wallet size)
  6. Official Transcript (most recent)

* (Please include any additional information you want to present.)

All materials should be sent to the following address by Friday, October 7, 2016.

Congressman Charles W. Dent
3900 Hamilton Blvd., Suite 207
Allentown, PA 18103

When a completed application is received the interview place, date and time will be scheduled by phone. Nomination interviews will begin Saturday, October 1, 2016. All completed forms and requested materials must be returned by Friday, October 7, 2016.

It is the responsibility of the applicant to ensure that the application packet is submitted to the correct congressional office. Packets submitted to this office in error will not be forwarded.