ELEANOR HOLMES NORTON



Margins: 1” Top, Bottom, Left, and Right.Typefaces: Times New Roman 12 pt. or Arial 12 pt.Tabs: Default every 0.5”Word 2010Congresswoman Norton’s Service Academy Applicant Information SheetName:Last, First, MiddlePermanent Address:Washington, DCZip:Mobile:()Landline:()E-Mail:Social Security Number:--Birth Date://MM/ DD/ YYYYWeight:Height: Visual Acuity:High School:Graduation Year:Parents’ or Guardian’s Name(s):I seek Nominations to:___US Military Academy___US Naval Academy___US Air Force Academy___US Merchant Marine AcademyAre You Also Seeking A Nomination From Another Source? The President The Vice President A Senator Other:Temporary, School, or Military Address Complete only if this is applicable to you. Service: ARMY USN USMC USAFUSCGUnit or School:Rank:Address:City:State:Zip:Country:Email your completed Applicant Information Sheet to Norton.Academy@Mail..Include your last name and first name in the subject line.Congresswoman Norton opens your application for nomination upon its receipt.Applicant Checklistright685800Attach or insert 2” x 2” (Passport Size) photo here.Write your name on the back of the photo.00Attach or insert 2” x 2” (Passport Size) photo here.Write your name on the back of the photo.Return your completed application with this signed and dated checklist to:Congresswoman Eleanor Holmes NortonATTN: Cartwright Moore90 K ST NE STE 100Washington, DC 20002-4203This checklist and all related materials are due at 5:00 p.m., Tuesday, November 1, 2016.Name:Last, First, MiddlePermanent Address:Washington, DCZip:Mobile:()Landline:()E-Mail:Science/Math Recommendation “A” Requested From: _NameRecommendation “B” Requested From: _NameRecommendation “C” Requested From: _NameOfficial High School Transcript Showing Senior Classes Requested.Official College/Prep School Transcript Requested.I requested the SAT send my scores to code 5462 and/orI requested the ACT send my scores to code 7319I plan to take or retake the SAT on (date) ____ and/orI plan to take or retake the ACT on (date) I applied to the Academy to which I seek a nomination.I certify I am domiciled in the District of Columbia, a Citizen of the United States, and this application is my own work product.Signature:Date:Congresswoman Eleanor Holmes Norton2017 Service Academy Application QuestionnairePlease repeat each question before your answer. Use Twelve (12) Point Type and limit your answer for each question to one-half page.What are the most significant contributions you have made to your school and to your community?What are your greatest strengths and weaknesses?What is your most outstanding achievement? Please explain why you consider this so.What experiences have prepared you for the rigors and demands of the Academy experience?Please provide examples of your leadership abilities.List your team and sports participation. Note leadership positions and honors you received.Please describe your work, volunteer, extracurricular, and/or community activitiesWhat are your academic interests?List your academic awards, honors, and prizes in order of importance to you.What books you have recently read? Please explain which ones you found interesting or enjoyable. Please describe any of your experiences, traits, and/or accomplishments, not previously mentioned in this application, which you feel the Selection Board might helpful in knowing you better.If an Academy offers you an appointment and you accept, what Military Occupational Specialties (MOS), Commissioned Officer Designators, or Air Force Officer Specialty Codes (AFSC), or job in the military might you pursue upon receiving your commission? Why do these fields of service interest you?Should you receive an offer of appointment to an Academy that is not your first choice, will you accept that offer of appointment?Attach your doubled-spaced essay of 250-500 words explaining why you desire to attend a U.S. Service Academy.Candidate Name:The above-named candidate seeks a nomination to a U.S. Service Academy from Congresswoman Eleanor Holmes Norton. The transcript must list the candidate’s senior year courses and, if available, any mid-term grades. Kindly mail or email the candidate’s official transcript to:Congresswoman Eleanor Holmes NortonATTN: Cartwright Moore, Service Academy Nominations90 K ST NE STE 100Washington, DC 20002-4203Voice: (202) 408-9041 & Fax: (202) 408-9048, E-mail: Norton.Academy@Mail.. Direct your questions to Cartwright Moore. Mr. Moore’s contact information appears above. The Congresswoman should receive official transcripts by 5:00 p.m. Tuesday, November 1, 2016.left274320000Congresswoman Eleanor Holmes NortonScience/Math Teacher Recommendation for Service Academies – A Due November 1, 2016This is my appraisal of (Candidate Name): promise as a student at a United States Service Academy.Other Forms Are Acceptable. You May Use Additional Pages.Signature:Date:Printed Name:Address:City: State: Zip:Nature and Length of Acquaintance with Candidate:Scan & E-Mail to: Norton.Academy@Mail.. or mail to: Cong. Eleanor Holmes NortonATTN: Cartwright Moore90 K ST NE STE 100WASHINGTON, DC 20003-4203Voice: (202) 408-9041 & Fax: (202) 408-9048Congresswoman Eleanor Holmes NortonRecommendation for Service Academies – B Due November 1, 2016This is my appraisal of (Candidate Name): promise as a student at a United States Service Academy.Other Forms Are Acceptable. You May Use Additional Pages.Signature:Date:Printed Name:Address:City: State: Zip:Nature and Length of Acquaintance with Candidate:Scan & E-Mail to: Norton.Academy@Mail.. or mail to: Cong. Eleanor Holmes NortonATTN: Cartwright Moore90 K ST NE STE 100WASHINGTON, DC 20003-4203Voice: (202) 408-9041 & Fax: (202) 408-9048Congresswoman Eleanor Holmes NortonRecommendation for Service Academies – C Due November 1, 2016This is my appraisal of (Candidate Name): promise as a student at a United States Service Academy.Other Forms Are Acceptable. You May Use Additional Pages.Signature:Date:Printed Name:Address:City: State: Zip:Nature and Length of Acquaintance with Candidate:Scan & E-Mail to: Norton.Academy@Mail.. or mail to: Cong. Eleanor Holmes NortonATTN: Cartwright Moore90 K ST NE STE 100WASHINGTON, DC 20003-4203Voice: (202) 408-9041 & Fax: (202) 408-9048 ................
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