Senator Heidi Heitkamp United States Senator for North Dakota

Service Academy Form

Academy Nominations

Are you a U.S. citizen?
Are you a legal citizen of ND?
Either parent a career military service member?:
Sibling(s) attending/have attended a Service Academy?:

If you are interested in attending more than one Service Academy, please rank in order of preference (1 - 4 with one being your first choice) the Academies to which you would accept nomination. If you do not mark an Academy, you will not be considered for this Academy.

Please indicate if you are seeking nominations from any of the following sources:

It is in your best interest to request a nomination through all sources available to you. If your father or mother is active duty military, retired military, or was killed in action, you may be eligible for a Presidential or Vice Presidential nomination. Please consult the Service Academy Information Sheet for applicable addresses.

Have you ever attended one of the Academy Summer Seminars?:
Have you ever been contacted directly by an Academy?
Have you ever served in the military in any capacity?

Test Scores:


Are you scheduled to re-take any of your tests?

Please use the text fields below to note your involvement in extracurricular activities. Use your discretion to detail pertinent specifics about your involvement in these activities, such as dates of involvement.

Include name of sport(s) you have participated in; position played; years participated; special recognitions, etc.
e.g. JROTC, Band/Orchestra, Student Government
e.g. Scouting, religious, volunteer activities
e.g. Include pertinent information regarding nature of job, including name of position and the dates you have held the position.