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Service Academy Form

Your Information

Full Name*

Permanent Address*

Mailing Address(if different)

Email*

Telephone Number

Date of Birth*

County*

City*

US Citizen?

Resident in AZ06?

Academy Ranking

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

U.S. Air Force Academy

U.S. Merchant Marine Academy

U.S. Military Academy (West Point):

U.S. Naval Academy:

Other Sought Nominations

ROTC Applications

ROTC App. Locations

Parent/Guardian Information

Father's Name

Father Phone

Mother's Name

Mother Phone

Academic Information

High School

Expected Graduation Date*

Counselor

Counselor Phone

SAT

Test 1 Math

Test 1 Verbal

Test 1 Writing

Test 2 Math

Test 2 Verbal

Test 2 Writing

Test 3 Math

Test 3 Verbal

Test 3 Writing

ACT

Test 1 English

Test 1 Math

Test 1 Reading

Test 1 Science

Test 2 English

Test 2 Math

Test 2 Reading

Test 2 Science

Test 3 English

Test 3 Math

Test 3 Reading

Test 3 Science

Athletic Activites

Sport

JV/V

Awards/Honors

Grade

Extracurriculars (School Sponsored)

Activity

Position Held

Awards/Honors

Grade

Community/Volunteer (Not school Sponsored)

Activity

Position Held

Awards/Honors

Grade

Other Awards

Awards/Honors

Grade

Employment Synopsis

Details*