2022 U.S. Military Academy Nomination Application for Congressman Joe Neguse (CO-02)

U.S. Military Academy Nomination Application for Congressman Joe Neguse

Application Deadline - October 1, 2022 All candidates will be notified by email regarding interview dates by October 15, 2022.
I. Personal Information:
Upload a Photograph: (Please consider the professional nature of this application when selecting a photograph):
Full Name *

First Name Middle Name Last Name Suffix
Birthdate: *

Month Day Year
Mobile No. : *

Area Code Phone Number
E-mail : *
Where the confirmation will be send to
Home Address : *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country
My primary residence is located within the Second District of Colorado

Yes No
Name(s) of Parents or Legal Guardians: *

First Name Middle Name Last Name Suffix
Name(s) of Parent(s) or Legal Guardian(s):

First Name Middle Name Last Name Suffix
Parent(s) or Legal Guardian(s) Address If Different From Above

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country

Please check all Academies that you are seeking a nomination for (You must start the application process at each academy for which you are seeking a nomination prior to your interview date). *

	Yes	No
US Air Force Academy
US Merchant Marine Academy
US Military Academy
US Naval Academy

Academy Preference: Please rank from 1-4 your preference. Make sure you mark your preferences correctly as it will help us in determining nominations. Again, you must start the application process at each academy for which you are seeking a nomination prior to the interview date. *

	Preference 1	Preference 2	Preference 3	Preference 4	Not applying to this academy
US Air Force Academy
US Merchant Marine Academy
US Military Academy
US Naval Academy

Are you seeking a nomination through another office: If so, check all that apply *

	Yes	No
US Senator Michael Bennet
US Senator John Hickenlooper
US Vice President Kamala Harris
US President Joe Biden
Other

Demographic Questions:
Information regarding gender, ethnic origin and race are optional. We ask these optional questions to help ensure that we are attracting candidates of diverse perspectives and backgrounds. Your response is optional and will not affect your nomination in any way.
Gender:

Male Female
Race/Ethic Identification

Black Hispanic Native American Asian Caucasian
Secondary (fluent) language, please mark all that apply:

Arabic Chinese Farsi French Russian Spanish Vietnamese
Family Income

<$25K $25K-74.9K $75K-124.9K $125K-174.9K >175K
Are you a first generation college student ?

Yes, I am the first among my parents or grandparents to attend college. No, my parents or grandparents have attended college.
Are you from single parent family?

Yes No
Are you a US citizen?

Yes No
Have you ever lived outside the United States of America?

Yes No
Have any members of your family attended an academy? If so, please select the academy:
II. High School Information:
Name of High School:
Year of High School Graduation:
Guidance Counselor Name:
Guidance Counselor Phone number:
Most recent cumulative unweighted GPA:
Most recent cumulative weighted GPA:
Class Rank (after Junior Year):
Class Size:
Are you or will you be a May 2022 high school graduate?

Yes No
Upload Official School Transcript
III. Academic Honors and Awards:
Extra-Curricular Activities:

Boys'/Girls' State Student Gov't Drama/Theater National Honor Society Student Council Member Officer in non-school club Civil Air Patrol Editor/Publisher School yearbook/paper School Band/Chorus Science Club Officer in School Club Language Club Community Service Club Eagle Scout Church Group JROTC
Athletics:

Basketball Wrestling Baseball/Softball Tennis Swimming Volleyball Track and Field Cross Country Soccer Gymnastics Diving Football Lacrosse Field Hockey Golf Spirit Skiing
Have you participated in varsity level sports?

Yes No
If yes, please list all sports played at the varsity level
Scholastic/Athletic: Honors and Awards (list as year/grade/honor award)
Employment History: (List as employer/date/job description)
Community Service: (List duration/hours per week/description)
IV. ACT/SAT Information:
SAT scores can be sent to this office with reporting code: 6197

ACT scores can be sent to this office with reporting code: 7301
Date you took the SAT:

Month Day Year
Evidence-Based Reading and Writing
Math Score:
Essay Score (optional) :
Next Test date:

Month Day Year
Date you took the ACT:

Month Day Year
ACT composite (overall) score?
ACT Math score:
ACT English score:
ACT Science score:
ACT Reading score:
Next Test date:

Month Day Year
All candidates reporting an SAT or ACT score will be asked to provide official verification. If your official ACT/SAT scores are included on your official transcript, you do not need to upload to this website. Providing an altered or false report of test scores will result in your application being dismissed without further consideration.
Upload SAT or ACT documents here

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V. For Students Currently Enrolled in Post-Secondary Education:

(college, university, trade/vocational school)
Name of School
Major / field of study:
Approximate credit hours completed by May 2022:
Current GPA:
School activities, honors, offices held, etc.:
Have you applied for a nomination before?

Yes No
If yes, when:

Month Day Year
VI. Essay
Essay 1: Please write a personal statement in 500 words or less describing why you wish to attend a U.S. Service Academy, including attributes that would make you successful at your desired academy.

Essay 2: Please describe, in 500 words or less, a challenging situation you were faced with, how you overcame the challenge, and what lessons you learned.

*You may choose to upload your essay or write them in the space provided*
Upload Essay 1

Browse Files

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Essay 1: *

0/500
Upload Essay 2

Browse Files

Cancel of
Essay 2: *

0/500
VII. Recommendation letters:

Please enter each reference's information. One from a math teacher, one from an english/writing teacher, and one from a principal or counselor. You may not use a family member as a reference. Your references will use the separate reference form to submit their letters of recommendation and supplemental information on your behalf.
Recommendation 1
Name of reference:
Phone number of reference:
Email of reference:
What is your relationship to the reference?
Recommendation 2
Name of reference:
Phone number of reference:
Email of reference:
What is your relationship to the reference?
Recommendation 3
Name of reference:
Phone number of reference:
Email of reference:
What is your relationship to the reference?
It is your responsibility to ensure each reference has a copy of this letter and submits it to our office on your behalf. The reference can email, mail, fax, or hand deliver this form to our office. We must have the form returned to us no later than 11:59 pm on October 1st, 2022. *
VIII. Applicant's E-Signature
I release this information to the Office of Congressman Joe Neguse for the use in the Service Academy Process. If I am selected for a nomination, I authorize Congressman Neguse to release my name and photo in press releases.

By signing (typing your legal name) in the space below, you are certifying:

I am a legal resident of the State of Colorado and of the Second Congressional District.

I have read all of the information in the application packet and I am aware of the procedure and requirements necessary for obtaining a service academy nomination from U.S. Congressman Joe Neguse.

I give my permission to Congressman Joe Neguse's Office to use my photo/video/quote and my name in constituent-related mail and website materials that may be mailed or emailed electronically by the Congressman's office.

If I have not submitted ALL required documents by October 1, 2022, I understand that I will not be given further consideration for a nomination this year.

When you press the submit button, you will receive an email confirmation that your application was received. Please print for your records and retain as verification of your application.

Application Checklist *

	Completed
Photo Uploaded
Application form completed
Essays
Contact information for three references
Unofficial transcript submitted
ACT/SAT scores submitted

Signature:
For additional information or to check on the status of your file, please contact Shane Atkinson at (970) 372-3971 or at shane.atkinson@mail.house.gov.

Note: Information submitted with your application cannot be returned. Information submitted with your application is subject ot the Privacy Act of 1974, 5 U.S.C Section 552(a), as amended and to the Freedom of Information Act, Section 552, as amended.
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U.S. Military Academy Nomination Application for Congressman Joe Neguse

I. Personal Information:

Demographic Questions:

II. High School Information:

III. Academic Honors and Awards:

IV. ACT/SAT Information:

V. For Students Currently Enrolled in Post-Secondary Education:

VI. Essay

VII. Recommendation letters:

Recommendation 1

Recommendation 2

Recommendation 3

VIII. Applicant's E-Signature