Service Academy Nominations

Contact Information

Prefix: *

First Name: *

Last Name: *

Suffix:

Preferred Name:

SSN:

Email Address: *

Street Address: *

Street Address: (Continued)

City: *

State: *

Zip Code: *

Phone Number: *

Date of Birth: *

Place of Birth (City, State/Country)

Gender: *

U.S. Citizen? * Yes No

Are you a legal resident of the 31st District? * Yes No

Parent/Guardian Information

Names of Parents/Guardians: *

Street Address: *

City: *

State: *

Zip Code: *

Education Information

High School Name: *

High School Phone Number: *

High School Address: *

City: *

State: *

Zip Code: *

Graduation Date:

Counselor's Email Address: *

Counselor's Phone Number: *

GPA: (Please have your counselor convert this to the 4.0 scale) *

Class Size:

Class Rank:

Have you taken or are currently enrolled in (check all that apply):

Honors Classes

AP Classes

IB Program

Dual Credit Classes

Please indicate your academic status

High school senior

Attending an Academy prep school

College (any classification) attending on a civil prep scholarship

College (any classification)

Other

If you selected other, please specify:

If you are a high school graduate, where are you currently attending:

College Address (Street, City, Zip)

College Phone Number: *

Official College Transcript must be included with completed application.

College Hours Completed:

College GPA:

Member of the armed forces? (ROTC, Natl. Guard, Reserves, Active Duty)

Yes

No

If you are a member of the armed forces please complete the following three questions:

Assignment:

Location:

Commanding Officer:

Academy Preference(s)

First Pick:

Second Pick:

Third Pick:

Fourth Pick:

You must open a pre-candidate file at any academy you are interested in.

To which academy(s) have you applied and when?
*Please note that the U.S. Coast Guard Academy does not require a Congressional nomination.

You are highly encouraged to apply to other available nominating sources.

Check all other sources to which you are applying:

Senator Cornyn

Senator Cruz

Vice President

President*

(*A Presidential Nomination only applies to applicants who have a parent currently on active military duty or a parent retired from active duty.)

Have you ever been arrested, charged or indicted in conjunction with a misdemeanor or felony?

Yes

No

If yes, provide details:

SAT Test Scores

Math:

Writing:

Critical Reading:

Composite:

ACT Test Scores

Math:

English:

Reading:

Science:

Composite:

I. Extracurricular Activities (School Affiliated/Non-Sport):

(List Organization/Activity, Positions Held, Hours Per Week & Total Time Spent, Awards/Recognition.)

II. Athletic Activities (Sports: School or Club/Marching Band):

(List all sports you have participated in as an individual or part of a team &/or list participation in marching band. Include Sport/Activity, School/Club, Position/Specialty Instrument, Hours Per Week & Total Time Spent, Awards/Recognition/Letter.)

III. Extracurricular Activities (Non-School Affiliated)

(List Organization/Activity, Positions Held, Hours Per Week & Total Time Spent, Awards/Recognition. Include civic, church, hobbies and special interest groups.)

Employment History

(Please list any part or full-time jobs you have held since you have been in high school. Note: List dates worked for each employer (to-from) as well as the employer address, position, and hours per week worked.)

Awards/Honors/Scholarships

(List 5 that most exemplify your commitment to excellence. Include name of award, year received, presenting organization, and award criteria for each award.)

References

Three letters of recommendation are required for your packet. Please do not send more than the required three. One must be from a high school teacher, coach, principal or guidance counselor. The other two character references are at the applicant's discretion. Those individuals providing a letter of recommendation should return them to you in a sealed envelope for inclusion in your packet or send them directly to Congressman Carter's service academy liaison team via email or mail at the addresses indicated.

Reference Name 1:

Reference Name 2:

Reference Name 3:

Acknowledgments

The information above is true and correct to the best of my knowledge. It is my sincere desire to attend a U.S. Service Academy, and I fully intend to accept an appointment, if offered. I am a U.S. citizen or will be by the designated Service Academy date. I am or will be at least 17, but not yet 23 years of age (USMMA: 25 years of age), by the designated Service Academy date. I am unmarried, not pregnant, and have no child support obligation. I am a legal resident of the 31st Congressional District of Texas.

I request that Congressman Carter consider my application for a congressional nomination to the U.S. Service Academy, or Academies, I have indicated. I request Congressman Carter to monitor my progress in seeking an appointment to an Academy, and hereby consent for the Academy to divulge information from my records for this purpose.

Provisions of the Privacy Act of 1974 are waived to the extent of sharing this information with the Service Academies and their representatives as well as members of Congressman Carter's Service Academy Advisory Board.

I understand that my application file must be completed by the deadline. If I have not completed and postmarked or delivered to Congressman Carter ALL the required information and documentation by that date, I understand that my application will not be given ANY consideration.

In the event that I do receive a nomination, I authorize Congressman Carter's office to releasethis information to the news outlets and the public.

In the event that I do receive an appointment and I accept said offer of appointment, I authorize Congressman Carter's office to release this information to the news media and the public.

Applicant Name:

Date:

Parent/Guardian Name:

Date:

Parent/Guardian Name:

Date:

Additional Files:

Please upload a photo of the nominee:

Please upload resume:

Please upload a personal essay:

Please upload transcripts:

Please upload any additional documents:

Documents must be the following file types: .doc, .docx, .pdf, .txt, .jpg, .png, .jpeg

Macintosh users: Your document must have a file extension. Resave it using your word processor with the appropriate extension from the above list.

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