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

Uncorrected Vision

Corrected Vision

High School
Test Scores

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

SAT

ACT

College
Parents/Guardians

Father

Mother

Other Family
Employment

(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.

Human Validation
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, September 29, 2017.

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 7, 2017. All completed forms and requested materials must be returned by Friday, September 29, 2017.

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.