Your Contact Information

Prefix

First Name * First Name is required.

Last Name * Last Name is required.

Suffix

Email Address * Email address is required. Invalid email address.

Street Address * Street Address is required.

City * City is required.

State * AL AK AZ AR CA CO CT DE DC FL GA HI ID IN IL IA KS KY LA ME MD MA MI MN MS MO MT NE NV NH NJ NM NY NC ND OH OK OR PA RI SC SD TN TX UT VT VA WA WV WI WY AA AE AP AS FM GU MH MP PR VI

Zip Code * Zip code is required. Zip code has to be a number.

Phone Number * Contact Phone Number is required. Phone number must be 10 digits.

Date of Birth * Date of Birth is required.

Gender * Gender is required.

US Citizen *

Yes
No Citizenship status is required.

Country of Citizenship

Parent/Guardian Information

Parent/Guardian Name * Parent/Guardian Name is required.

Street Address * Parent/Guardian Street Address is required.

City * Parent/Guardian City is required.

State * AL AK AZ AR CA CO CT DE DC FL GA HI ID IN IL IA KS KY LA ME MD MA MI MN MS MO MT NE NV NH NJ NM NY NC ND OH OK OR PA RI SC SD TN TX UT VT VA WA WV WI WY AA AE AP AS FM GU MH MP PR VI

Zip Code * Parent/Guardian Zip code is required. Parent/Guardian Zip code has to be a number.

Education Information

High School Name * High School Name is required.

Street Address * High School Street Address is required.

City * High School City is required.

State * AL AK AZ AR CA CO CT DE DC FL GA HI ID IN IL IA KS KY LA ME MD MA MI MN MS MO MT NE NV NH NJ NM NY NC ND OH OK OR PA RI SC SD TN TX UT VT VA WA WV WI WY AA AE AP AS FM GU MH MP PR VI

Zip Code * High School Zip code is required. High School Zip code has to be a number.

GPA * High School GPA is required.

Class Size

Rank

Graduation Date

SAT Test Scores

Math

Writing

Critical Reading

Composite

ACT Test Scores

English

Math

Reading

Science

Composite

Academy Information

First Pick U.S. Air Force Academy U.S. Military Academy U.S. Naval Academy U.S. Merchant Marine Academy

Second Pick U.S. Air Force Academy U.S. Military Academy U.S. Naval Academy U.S. Merchant Marine Academy

Third Pick U.S. Air Force Academy U.S. Military Academy U.S. Naval Academy U.S. Merchant Marine Academy

Fourth Pick U.S. Air Force Academy U.S. Military Academy 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
No

Additional Information

Extracurricular Activities

Name of Hometown Newspaper

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

Yes
No