Full Name:

Name of Parent/Guardian:

Permanent Address:

Temporary Address (if different):

Telephone Number:

Social Security Number:

Date of Birth:

Male
Female

High School:

Year of Graduation:

Academy Preference (rank 1-4):

I have taken/will take the SAT:

SAT scores (if known)

GPA

I will ask the following persons for letters of recommendation:

1.

2.

3.

I am also seeking a nomination through:

I am a citizen of the United States, or I will have attained citizenship before I enter the Academy. I am a legal resident of the State of Washington. I understand that I must submit all necessary information by November 15, 2009 to be considered for a nomination by U.S. Senator Patty Murray.

Signature:

Date:

Compile all information (application, high school transcript, three letters of recommendation, SAT scores, list of activities and essay) and send them together in the same packet to Senator Murray's Seattle office, if you have already not done so.

Please send to:

U.S. Senator Patty Murray
2988 Jackson Federal Building
915 2nd Avenue
Seattle, Washington 98174
ATTN: Mr. Kim Brown

Phone: (206) 553-5545
Fax: (206) 553-0891

All information must be received in our Seattle office by November 15, 2009.

Mail to our Seattle office only. Please do not send any part of the application to Senator Murray's Washington, D.C. office.

CHECKLIST

Senator Murray's application

Three letters of recommendation, at least one from your
      high school counselor or principal

A sealed, certified copy of your high school transcript

SAT scores

A list of your activities and accomplishments

250-word essay




  Print Form