By signing below, I am requesting that Congressman Ken Buck consider my application for a Congressional Nomination to a U.S. Service Academy that I have listed. I understand that I am applying for a Congressional Nomination and that the Military Service Academy will make the actual appointment. I further understand it is my responsibility to understand and complete the application process for the Service Academy(ies), including the Medical Entrance exam.
I hereby certify that I am a legal resident of the Fourth Congressional Disitrict of the State of Colorado and meet all of the eligibility requirements as stated in the information guide and application provided by the office of Congressman Ken Buck. I further affirm that I have never been convicted or arrested for violating a state or federal statute.
I understand that the deadline for this application is October 1, 2017. It is my responsibility to ensure that all parts of my application have been recieved by Congressman Buck's office, and if I have not submitted all of the requested information by October 1, 2017, I understand that my application will not be considered.
I, the undersigned, certify that all information contained in this application is correct to the best of my ability. I certify that Congressman Buck and his staff have permission to take any photographs at an event pertaining to my Service Academy nomination request, and that my personal information within this application, including my personal photograph, will be shared only with individuals assisting in the nomination process, including Congressman Buck, his staff, and his Service Academy panelists.