**APPLICATION\
FOR**

**NOMINATION**

**TO THE**

**UNITED STATES\
SERVICE ACADEMIES**

# Congressman Dennis Cardoza

**18^th^ Congressional District - California**

**1010 Tenth Street, Ste 5800**

**Modesto, CA 95354**

**(209) 527-1914**

**[INSTRUCTIONS FOR ACADEMY APPLICANTS]{.underline}**

**Please read the following instructions and review the entire
application for completing it.**

1.  Please type your application. The enclosed application **MUST** be
    used and any other will not be accepted.

2.  The following items must be sent to our office by **[November 7,
    2008]{.underline}** to allow time for consideration of your
    application.

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A.  The enclosed standard application form. Please make sure all
    information necessary is included on this form.

B.  Two letters of recommendation from someone who knows you well.
    Please ask the person submitting the recommendation to include their
    address, phone number and their relationship to you.

C.  A copy of your high school transcript.

D.  A recent photograph of yourself.

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3.  We will need a copy of your SAT or ACT test scores by November
    7, 2008. To send your scores directly to Congressman Cardoza, use
    the Congressional Code #4135 for SATs and Code #7257 for ACTs when
    you are choosing the destination of your scores.

4.  On your application, please distinguish between and activity and an
    office held in the activity. For example, being a member of the
    drama club is an extra-curricular activity. Being the treasurer of
    the drama club, however, would be listed as an office held. The same
    distinction needs to be made between sports participation and sports
    achievements.

5.  If the activity is school-related, please list the grade you were in
    at the time of participation.

6.  If you have any questions, please contact Lisa Mantarro Moore (209)
    527-1914 or by email at <Lisa.Mantarro@mail.house.gov>.

7.  Your application, letters of recommendation, high school transcript
    and SAT/ACT scores should be mailed or delivered to:

> Congressman Dennis Cardoza
>
> 1010 Tenth Street, Ste 5800
>
> Modesto, CA 95354

We must receive you completed for no later that **[November 7,
2008]{.underline}** to be eligible for consideration. Also, remember you
must also apply to the academy directly in order that your name will be
placed in the computer system and to complete their application for
admittance.

**APPLICATION** *(please type)*

**[FULL LEGAL NAME:]{.underline}**

**\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_**
Last Name First Name Middle Name Common Name Used

**­­­­­­­­­­­­­­­­­­­­\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_**
Permanent Address City/State/**Zip+four**

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Home Telephone Number Cell Phone Number

**\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_**
Birth date Age Height Weight

**\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_**
High School Date of Graduation

**\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_**
GPA Rank in Class of SAT1 Verbal/ Math/Writing Composite ACT

Are you a United States Citizen? \_\_\_\_\_\_\_\_\_\_

Email Address

**[Academy -- Number in order of preference:]{.underline}**

( ) Air Force ( ) Annapolis (Navy) ( ) Military (West Point) ( )
Merchant Marine

**[Parent/Guardian Information:]{.underline}**

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Father's Name Living Deceased

**\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_**
Occupation

**\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_**
Mother's Name Living Deceased

**\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_**
Occupation

Previous Military
Background**\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_**

# 

# [EXTRA CURRICULAR ACTIVITIES:]{.underline} *(Indicate Grade- High School Only)*

\_\_\_\_\_Boy's State \_\_\_\_\_Eagle Scout \_\_\_\_\_School Band/Chorus

\_\_\_\_\_Girl's State \_\_\_\_\_Boy/Girl Scout \_\_\_\_\_Jr. ROTC

\_\_\_\_\_Class Officer \_\_\_\_\_Nat'l Honors \_\_\_\_\_Student
Government

\_\_\_\_\_Science Club \_\_\_\_\_Key Club \_\_\_\_School Paper/Yearbook

\_\_\_\_\_Other\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Employment:\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Hours Per Week:\_\_\_\_\_\_\_\_\_\_\_\_\_\_After
School\_\_\_\_\_\_\_\_\_\_\_\_\_\_Summer\_\_\_\_\_\_\_\_\_\_\_\_\_

[**EXTRA CURRICULAR ACTIVITIES**:]{.underline} *(List all activities --
use additional sheets if necessary)*

[**SPORTS ACTIVITES**:]{.underline} *(List if Captain or Co-Captain)*

Please attach an autobiographical essay -- one page, double-spaced - of
why you would like wish to attend an Academy. Please type.

**Mail Application to:** Congressman Dennis Cardoza

1010 Tenth Street, Ste 5800

Modesto, CA 95354

Attn: Lisa Mantarro Moore

\(209\) 527-1914