Service Academy

Current Information
Attachments
Complete

1 of 3

Indicates required field

Academy Information

Number your preference (1 to 4) of academies -- with 1 being your highest preference.

U.S. Air Force Academy:

U.S. Military Academy (West Point):

U.S. Naval Academy:

U.S. Merchant Marine Academy:

An appointment to the Service Academies is based on a desire by the candidate to devote a lifetime of military service and implies recognition by the appointee of an obligation to the government to devote him / herself to a military career.

Are you interested in an appointment on that basis?

Yes

Are you requesting a nomination to a service academy from source other than Congressman Williams?

Please include name and/or type of nominating source, i.e. Presidential, Foundation, etc.

Personal Information

Prefix:

First Name:

MI:

Last Name:

Suffix:

Home Address

Address

Address 2

City

State

ZIP

Email:

Cell Phone Number:

Home Phone Number:

Date of Birth:

Month

Day

Year

Place of Birth:

Gender:

Female

Male

U.S. Citizen?

Yes

If not, list your country of citizenship:

Parents Information

Parents/Guardians:

Parent or Guardian Phone Number:

Education Information

Name of High School:

High School Street Address:

Address

Address 2

City

State

ZIP

High School Counselor's Name:

Counselor’s Email:

Counselor’s Phone Number:

Graduation Year

Class Rank:

Class Size:

GPA:

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

Current College GPA

Please fill out all fields in either SAT or ACT scores.

SAT Scores

Critical Reading:

Math:

Composite:

ACT Scores

Math:

English:

Reading:

Science:

Writing:

Composite:

Additional Information

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:

Please list all memberships and leadership positions in clubs and organizations including ROTC and any community service or church-related activities. Include any honors you have received in relation to these activities:

Certification

ANY DESIRE TO CHANGE YOUR ORDER OF PREFERENCE REQUIRES A NEW APPLICATION

I certify that my answers are true and complete to the best of my knowledge. I understand that provisions of the Privacy Act of 1974 are waived to the extent of sharing this information with the service academies, their representatives, and members of the Candidate Selection Board. Additionally, I understand that if a nomination or an
appointment is offered to me by a service academy, any announcement to the news media will be made by Congressman Williams only.

Type your full name to agree to the above:

Today's Date:

CAPTCHA: enabled to secure this form.

If you are having difficulty using Captcha's visual option, please visit the Accessibility page for more assistance.