Thank you for your interest in the U.S. Service Academies. As your 6th District Representative in the U.S. House of Representatives, each year I have the privilege of nominating a limited number of people to four of the five service academies. The honor of attending a service academy comes with an obligation and commitment to serve in the military for a minimum of five years upon graduation. For more information, please review my page of Frequently Asked Questions for those seeking a Military Academy Nomination. Best wishes to you as you pursue your goal of attending one of the U.S. Service Academies and serving our country.

To request a Military Academy Nomination form my office, please complete the form below.

* indicates information that you need to provide.



Your Information
First Name *
Middle
Last Name *
* Date of Birth:
SSN (No Dashes):
* Address:
* City:
* State:
* Zip:
Gender:
U.S. Citizen?
Yes No
If not, list your country of citizenship:
* Please provide the names of your Parents/Guardians:
Home Phone Number:
Cell Phone Number:
* Email:
Education Information
* High School:
* High School Address:
* City:
* State:
* Zip:
* GPA:
Class Size:
Class Rank:
Graduation Date:
Test Scores

SAT Scores

Math:
Writing:
Critical Reading:
Composite:

ACT Scores

Math:
English:
Reading:
Science:
Composite:
Academy Information
Academy Preference: Indicate your preference in numerical order. Please do not designate any academy you would not accept. Due to the competitive nature of the nomination process, you may receive a nomination to the academy of your second, third, or fourth choice. (The U.S. Coast Guard Academy does not require a Congressional nomination.)
First
Second
Third

Fourth

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 No
Additional Information

EXTRACURRICULAR ACTIVITES
Remember to include:
  • Special awards and honors with dates.
  • School and outside club memberships and activities, noting leadership positions and honors received, with dates.
  • Employment, both after school and in summer, with dates and hours per week.
  • Volunteer involvement, with dates and hours per week.
  • School athletics (note Captain, Varsity letter, MVP, All-League, etc.) with dates.
  • Out-of-school recreational athletics, with dates.

Is it ok to use your name in a press release?

Yes No

Name of home town paper?



The information above is correct. I am a U.S. Citizen, or will be by July 1 of the year I will attend the Academy. I will be at least 17 years, but not yet 23 years of age, on July 1 of the year I attend the Academy. I am not married. I am not pregnant, nor do I have any child support obligations. I am a legal resident of the 6th Congressional District of Indiana.

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