Service Academy Nominations

Service Academy Information Form

Note: Fields marked with an * are required.

Thank you for your interest in the U.S. Service Academies. As the Representative for Florida's 11th Congressional District, each year I have the privilege of nominating a limited number of people to the 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 on seeking a nomination, please review my page of Frequently Asked Questions. Best wishes to you as you pursue your goal of attending one of the U.S. Service Academies and serving our country.

Name

First

Middle

Last

Permanent Address

City

State

FL

Zip

Mailing Address

(if different from above)

City

State

FL

Zip

Email *

Phone Number

Social Security Number

Date of Birth

(Note: Applicant must be at least 17 years old, but not have passed his/her 23rd birthday)

US Citizen

Yes

No

(Note: In order to enter the academy, an applicant who received an appointment must be a United States citizen at the time of entrance to the academy)

Choice of Academy

Please indicate order of preference (1, 2, etc.) and only those academies from which you would accept a nomination

Air Force

Merchant Marine

Military

Navy

Current Applications

Sen. Rubio

Sen. Nelson

Vice President

President

ROTC Applications

Have you applied for a ROTC scholarship?

Yes

No

If so, where?

Father's Name

Work Phone

Mother's Name *

Mother's Phone

Residency

Do you or your parents reside in the 11th Congressional District?

Yes

No

(Note: Applicant must be a resident of the 11th District to receive a nomination from Rep. Webster)

High School *

Guidance Counselor

Guidance Office Phone

Human Validation