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SenatorTomCotton’s2017NominationApplication PAGE1of10
U.S.SenatorTomCotton
NominationApplicationFORTHE
UnitedStatesServiceAcademies
PLEASEREADBEFORECOMPLETINGAPPLICATION:AcceptinganappointmenttoaServiceAcademyinvolvesfouryearsofstudy
followedbyaneight-yearminimumserviceobligation(withfiveyearsofactivedutyrequired).Itistoyouradvantagetoapplytomorethanoneacademyandtorequestanominationthroughallsourcesavailabletoyou:Presidential,VicePresidential,
SenatorialandCongressional.
OFFICIALDEADLINEPOLICY:Applicationpacketsmustbepost-markedonorbeforeFRIDAY,NOVEMBER3,2017.ApplicationswillnotbeacceptedbeforeAugust1,2017.PleasecontactRebekahHillmerifyoushouldexperiencetechnicaldifficultiesthatmightpreventyoufrommeetingthisdeadline.ApplicationsthatarepostmarkedafterthisNOVEMBER3rd
deadlinewillautomaticallybedisqualified.
HAVEYOUCONTACTEDYOURLOCALACADEMYLIAISON?TheSenatorialnominationmaterialsareseparatefromthematerialsyoumustprovidetotheacademies.Theserviceacademiesdesignatealumniwithineachcongressionaldistricttopre-screencandidatesandassistwiththeacademies’
applications.Toreceivetheacademy’sCandidateKitorApplication,candidatesmustdirectlycontacttheacademiestoopenanadmissionsfile.
Ifyouarestillunsurewhatthismeansorwouldlikehelpcontactingyourliaison(s),pleasecontactRebekahHillmerat(501)223-9081orbye-mailat
SenatorTomCotton’s2017NominationApplication PAGE2of10
SECTIONI.EligibilityRequirements
AsofJuly1oftheyearofadmission,applicantsmustbe:
ü 17yearsofage,butnotyet23ü AcitizenoftheUnitedStatesü Unmarried,notpregnant,andhavenolegalobligationtosupportachildordependentü AlegalresidentofArkansas
NOTE:Ifyourfatherormotherservedeightyearsinthemilitary,orwaskilledin
action,youmaybeeligibleforaPresidentialorVicePresidentialnomination.PleasecontacttheServiceAcademiesformoreinformation.
SECTIONII.InterviewsSenatorCotton’sAcademyLiaison,RebekahHillmer,willreviewapplicantswhocompleteanominationfileonorbeforeFRIDAY,NOVEMBER3,2017.EligiblecandidateswillbeinvitedtomeetwithSenatorCotton’sAcademyNominationBoardforaninterview.Thisprofessional,non-partisanboardensuresafairandimpartialprocessforallapplicants.Applicantsareexpectedtodressappropriatelyforthemilitaryacademyinterviews.Youngmenmayweardressslacksandshirt,andatie.Acoatisoptional.Youngwomenmaywearadressoraskirtordresspantswithablouse.NominationswillbeannouncedinJanuary2018.
SenatorTomCotton’s2017NominationApplication PAGE3of10
SECTIONIII.APPLICATIONREQUIREMENTSINDEX
ITEMSINCLUDEDINTHISPACKET:
ü Applicationform (PAGES4-6)ü Extra-curricularActivitiesWorksheet (PAGE6-7)ü InterviewBoardQuestionnaire (PAGES7-8)ü TermsofAgreement (PAGE9)ü FinalChecklist (PAGE10)
ITEMSNOTINCLUDEDINTHISPACKET:
ü 3LettersofRecommendation:Lettersmaybewrittenbyhighschoolprincipals,guidancecounselors,teachers,coaches,scoutmasters,orcommunityleaderswhocanaccuratelycommentontheapplicant’scharacter,abilitiesandpotentialforsuccessatanacademy.
ü SAT/ACTScores:Scoresmaybesubmittedwiththecandidate’sofficialhighschooltranscript.YouareencouragedtotaketheSATorACTexams“earlyandoften”inordertoimproveyouracademiccompetitiveness.Academieswillacceptthehighestscoresineachacademicarea,regardlessoftestingdate.
ü OfficialHighSchoolTranscript:Pleaseincludeacopyofyourseniorclassschedule.Seniorgradesmaybesubmittedassoonastheyareavailable.CounselorsmayfaxoremailthemandonlytheseniorgradesmaybeforwardedaftertheNovember3,2017deadline.IfAdvancedPlacement(AP)coursesaretaken,pleaseattachacopyoftheAPscoreswiththetranscript.
ü IdentifyingPhotograph:Pleaseattacharecent,professionalphotographofyourselfwiththisapplication.Photographswillnotbereturnedtothecandidate.Passportphotosarepreferred.
SECTIONIV.OfficeofU.S.SenatorTomCottonContact
ATTN:REBEKAHHILLMER1401WESTCAPITOLAVENUE,SUITE235
LITTLEROCK,AR72201PH:(501)223-9081
SenatorTomCotton’s2017NominationApplication PAGE4of10
U.S.SENATORTomCotton
OFFICIALNOMINATIONAPPLICATION
FULLNAME:________________________________________________________________________________________________________________________ (First) / (Middle) / (Last)DOB:________________________ AGE:________________ GENDER: M/F_ Iwishtobenominatedtothefollowingacademy(s)inthisorderofpreference:*NOTE:Rankonlytheacademiesforwhichyouhavefiledanapplicationandintendtointerview._____U.S.NavalAcademy _____U.S.AirForceAcademy_____U.S.MilitaryAcademy _____U.S.MerchantMarineAcademyIamapplyingforanominationfromthefollowingnominationresources(otherthanSenatorTomCotton):_____SenatorJohnBoozman_____U.S.Representative,pleasespecify:__________________________________Presidential_____VicePresidential_____JROTC _____None CONTACTINFOAPPLICANTINFOApplicant’sCell:(_______)______________________ Applicant’sEmail:________________________________PermanentMailingAddress TemporaryAddress(ifstudentisaway)______________________________________________________ ____________________________________________________________________________________________________________ ____________________________________________________________________________________________________________ ______________________________________________________County:____________________________________________ PARENTINFOFather’sName:__________________________________ Mother’sName:___________________________________Parent’sCell:(_______)____________________________ Parent’sCell:(_______)_____________________________Parent’sEmail___________________________________ Parent’sEmail:____________________________________NameofHighSchool:________________________________________________________________________________________________HighSchoolAddress:_________________________________________________________________________________________________HighSchoolPhone:(_______)____________________________ Counselor’sName:________________________________
SenatorTomCotton’s2017NominationApplication PAGE5of10
U.S.SenatorTomCotton
EDUCATIONALHISTORYDateofGraduation:________________ EstimatedClassRank&ClassSize:_______/_______GradePointAverage:______________ GradeScaleUsed:__________________________SATScores:Total:_________________ Verbal:________ Math:________ Date:__________ACTScores:Total:_________________ Math:________ English:________ Date:__________
Reading:________ ScienceReasoning:_________GradepointAverage,Scale,ClassRank&Sizemustbeincludedonyourhighschooltranscript.Homeschooledstudents–simplymarkrankinclassas1of1ifofficialrankingisunavailable.ACT/SATscoresreportedonyourofficialcertifiedtranscriptareacceptable.College(ifapplicable):______________________________________________________________GradePointAverage:___________ HoursCompleted:__________ Major:__________EMPLOYMENTHISTORYStartingwithmostrecent-useadditionalsheetsifnecessary.
Placeofemployment:_______________________________________________________DatesEmployed:__________________HoursWorkedperWeek:_______________MotivationforWorking:_______________________________________________________________________________________________________
Placeofemployment:_______________________________________________________DatesEmployed:___________________ HoursWorkedperWeek:__________MotivationforWorking:_______________________________________________________________________________________________________
SenatorTomCotton’s2017NominationApplication PAGE6of10
EXTRACURRICULARACTIVITESATHLETICACTIVITIES:Pleasecheckallthatapply.Mark“JV”JuniorVarsityor“V”Varsityintheappropriatespace.Alsospecifywithan“L”ifyouletteredinthesport.HIGHSCHOOL 9101112 NON-SCHOOLATHLETICS 9101112Baseball/Softball ________ Baseball ________Basketball ________ Basketball ________Cheerleading ________ Football ________CrossCountry ________ Golf ________DrillTeam ________ Gymnastics ________Football ________ Running ________Golf ________ Karate ________Soccer ________ Racquetball ________Swimming/Diving ________ Soccer ________Tennis ________ Softball ________Track/Field ________ Swimming ________Volleyball ________ Tennis ________Wrestling ________ Track/Field ________Other:____________________ ________ Volleyball ________Other:____________________ ________ Wrestling ________Other:____________________ ________ Other:___________________ ________EXTRA-CURRICULARACTIVITIES LEADERSHIPROLESStudentBodyRepresentative ________ Boys/GirlsState �Position:____________ Scouting ________ AthleticTeamCaptain �Sport:______________ ChurchActivities ________ Jr.ROTC �Rank:______________Band/Orchestra ________ StudentBodyPresident ________Music/Singing ________ ClassPresident ________ Drama ________ StudentBodyOfficer ________SchoolYearbook/Newspaper ________ EagleScout ________KeyClub ________ OtherMilitaryOfficer ________LanguageorScienceClub ________ OtherSchoolClubOfficer ________Jr.ROTC ________ Non-schoolClubOfficer ________CivilAirPatrol ________ Editor,Yearbook/Newspaper________CommunityService ________ Other:___________________ ________Other:____________________ ________ Other:___________________ ________AWARDSANDHONORS ACADEMYSUMMERSEMINARATTENDEDNationalHonorSociety ________ UnitedStatesNavalAcademy �Date:_________Other:____________________ ________ UnitedStatesAirForceAcademy �Date:_________Other:____________________ ________ UnitedStatesMilitaryAcademy �Date:_________
SenatorTomCotton’s2017NominationApplication PAGE7of10
U.S.SENATORTomCotton
INTERVIEWBOARDQUESTIONNAIREPleasetypeyouranswerstothefollowingquestions.Additionalpagesmaybeusedifdesired.Keepeachquestionunder500words.Whyareyouinterestedinattendingamilitaryserviceacademy?Whathaveyoudonetolearnmoreaboutwhatacommitmenttooneoftheacademiesentails? Whatdoyoufeelisyourstrongestpersonalattribute?
SenatorTomCotton’s2017NominationApplication PAGE8of10
Whatcharacteristicdoyouperceivetobeapersonalweaknessandwhatdoyoudotocompensateand/orimproveit?Whatroledoescompetitionplayinyourlife?Whatqualitiesdoyoufeelareimportantinaleader?Describealeadershiproleyouhaveheldandhowyou’veexhibitedanyoftheseleadershipqualities.
SenatorTomCotton’s2017NominationApplication PAGE9of10
U.S.SENATORTomCotton
LETTERSOFRECOMMENDATIONListthreeindividualswhowillwritealetterofrecommendationsupportingyournomination.Chooseindividualswhoknowyouwell,andcangiveinsighttoyourcharacter,abilitiesandpotentialforsuccessatanacademy. Name Phone Title/Organization
1) __________________________________(_______)_______________________________________________________
2) __________________________________(_______)_______________________________________________________
3) __________________________________(_______)_______________________________________________________
TERMSOFAGREEMENT
IcertifythatIhavereadthetermsofthedocumentthatIamsigning.
Iunderstandthedeadlineforthereceiptoftheapplicationpacket,officialhighschooltranscript,collegeaptitudetestscoresandallrecommendationlettersisNovember3,2017.
IunderstandthatapplicationpacketmustbesubmittedtotheLittleRock,Arkansas,OfficeofU.S.SenatorTomCottononorbeforeNovember3,2017.Ialsounderstandthatifmypacketispost-markedafterNovember3,2017,IwillautomaticallybedisqualifiedfromSenatorTomCotton’s
NominationApplicationcyclefortheyear2017.
IamalegalresidentoftheStateofArkansas.
Applicant’sSignature:______________________________________________Date:_________________________
Parent’sSignature:__________________________________________________Date:_________________________
SenatorTomCotton’s2017NominationApplication PAGE10of10
U.S.SenatorTomCotton
FINALCHECKLISTPleasecompletebeforesubmittingapplication.1) ___PhotoAttachedtoApplication2) ___CompletedApplicationForm(PAGES4-6)3) ___Extra-curricularActivitiesWorksheet(PAGES6-7)4) ___InterviewBoardQuestionnaire(PAGES7-8) 5) ___HighSchoolTranscript(withAPscoresifapplicable)6) ___SeniorClassSchedule7) ___ACT/SATScores(maybeonTranscript)8) ___ThreeLettersofRecommendation(PAGE9)Pleasemailyourcompletedapplication,requiredattachmentsandrecommendationsto:
U.S.SENATORTOMCOTTONATTN:REBEKAHHILLMER
1401WESTCAPITOLAVENUE,SUITE235LITTLEROCK,AR72201PH:(501)223-9081
