Congressman Ted Yoho

Representing the 3rd District of Florida

Service Academy Nominations Form

Instructions

Thank you for your interest in the U.S. Service Academies. As your 3rd 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 Service 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 Service Academy Nomination form from my office, please review the following attachments and complete the form below.

Indicates information that you need to provide.

Your Information

Prefix:

First Name:

MI:

Last Name:

Suffix:

Street Address:

Street Address Continued:

City:

State:

Zip Code:

U.S. Citizen: Yes No

If not, list your country of citizenship:

Contact Information

Email Address:

Telephone Number:

Parent Information 1

Parent/Guardian Name:

Parent/Guardian Phone:

Parent/Guardian Email

Relationship:

Parent Information 2

Parent/Guardian Name:

Parent/Guardian Phone:

Parent/Guardian Email

Relationship:

High School Information

Name of High School:

High School Street Address:

City:

State:

Zip Code:

Weighted GPA:

Unweighted GPA:

Class size

Rank

Graduation Date

Guidance Counselor Name:

Guidance Counselor Phone:

Guidance Counselor Email

College/University

Name of College:

Major:

Minor

GPA:

Advisor Name:

Advisor Phone:

Advisor Email

Test Scores

SAT Scores

Math:

Critical Reading:

Composite:

ACT Scores

English:

Math:

Reading:

Science:

Composite:

Academy Selection

First Choice:

Second Choice:

Additional Information

Name of hometown newspaper:

Is it okay to use your name in a press release after receiving a nomination or appointment?

Yes No

Congressman Ted Yoho

Representing the 3rd District of Florida

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