Upon graduation I expect to have completed the following courses (Yes or No):
U.S. Senator (Name and State):
U.S. Congressman/District (Name and State):
If Senators and Congressman have already been contacted, please list the date contacted:
If you have a nomination, state your candidate number:
Is your father or mother on active military duty or retired with 20 years of active service?
Do you wear glasses or contact lenses?:
If yes, indicate to the best of your knowledge your uncorrected visual examination readings:
Is your vision 20/20 with contacts or glasses?
Are you color blind?:
Please indicate below all non-athletic extracurricular activities in which you have participated:
This questionnaire is for evaluation
purposes by our coaching staff. It is not an application for admission to the Naval Academy. If you desire to become a candidate for admission we recommend that you complete the questionnaire for the admissions office at: www.usna.edu/Admissions/steps.htm