United States Naval Academy Admissions Banner OMB 0703-0036 EXP: RENEWAL PENDING

USNA Summer STEM Application

AGENCY DISCLOSURE NOTICE: The public reporting burden for this collection of information is estimated to average 6.75 hours per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing the burden, to the Department of Defense, Washington Headquarters Services, Executive Services Directorate, Directors Division, 4800 Mark Center Drive, East Tower, Suite 02G09, Alexandria, VA 22350-3100 (OMB 0703-0036).
Respondents should be aware that notwithstanding any other provision of law, no person shall be subject to any penalty for failing to comply with a collection of information if it does not display a currently valid OMB control number.

Please do not return your response to the above address.

Responses should be sent to: United States Naval Academy, Privacy Office, 121 Blake Road, Annapolis, MD 21402-1300
Click here for Privacy Act Statement.

Click here for Application Instructions.

Please read Application Instructions thoroughly. Failure to comply with instructions can jeopardize your chances of gaining acceptance to United States Naval Academy Summer STEM.

Please complete each section in the space provided.

Personal Information 
Last Name: (Required)
First Name: (Required)
Middle Name:
Birth Date:
(DD-MON-YYYY, e.g. 02-FEB-1988)
Citizenship: (Required)
If you are not a U.S. Citizen, please describe
your current status in the naturalization
process (years with green card, etc.):

(Limited to 500 Characters)
Gender: (Required)
(Inches, e.g. 5 feet 6 inches would be entered as 66)
Social Security Number:
(No Dashes)

Race: (Required)
(Check All that Apply)
American Indian/Alaska Native:
Black or African American:
Native Hawaiian or Other Pacific Islander:
Declined to Respond:

Ethnicity: (Required)
Current Mailing Address: (Required)
City: (Required, All Except APO/FPO)
APO/FPO: (Required, Military Post Offices Only)
State: (Required, State & U.S. Territories Only)
Country: (Required, International Only)
Zip Code: (Required, All Except International)
Zip Code Extension:
Postal Code: (International Only)
Email Address: (Required)
Area Code & Home Phone Number: (Required, Unless Area Code & Cell Phone Number is Entered)
Area Code & Cell Phone Number: (Required, Unless Area Code & Home Phone Number is Entered)
Congressional State: (Required)
Congressional District: (Required)

Click here for instructions or if you need assistance finding your Congressional District.

Please indicate how you first learned about Naval Academy Summer STEM: (Required)

First Name of Parent or Guardian: (Required)
Last Name of Parent or Guardian: (Required)
Relationship Type: (Required)
Area Code & Cell Phone Number: (Required)
Email Address: (Required)

Please enter the grade you will be entering in the next academic year: (Required)
Expected Year of High School Graduation:
High School Name:
If you are currently in junior high, enter your prospective high school

Click here for instructions or if you need assistance finding your High School.

Enter the highest scores you have received on the following College Entrance tests.
(Leave blank if you did not take one of the tests.)

SAT taken prior to 01-MAR-2016:
 SAT Math:SAT Critical Reading:SAT Writing:

SAT taken after 01-MAR-2016:
 SAT Math:SAT Evidence Based Reading and Writing:SAT Reading:SAT Writing and Language:

 ACT Math:ACT English:  
 PSAT Math:PSAT Critical Reading:PSAT Writing:

Does your high school or junior high rank students? (Required)

Enter your class standing. Please provide your best estimate if your school does not rank students. 
(Do Not Enter Percentages.) 

Class Rank: (Required)
Class Size: (Required)
Remarks or Additional Comments:
(Limited to 2000 Characters)

Grade Summary: (Required for All)
(IB/AP/H indicates International Baccalaureate, Advanced Placement or Honors course.) 

CoursesIB/AP/HGrade (90-100=A 80-89=B 70-79=C Not Taken=N)
English 7:
English 8:
English 9:
English 10:
Algebra I:
Algebra II:
Calculus 1:
Calculus 2:

Athletic Participation: (Required for All)Number of Sports
How many varsity sports have you participated in?:
How many sports have you earned a varsity letter in?:
How many sports teams were you designated as a captain?:
How many special awards for sports such as All-Star/All-State/District/City or County have you received?:
How many club, intramural or junior varsity sports have you participated in?:
Non-Athletic Participation: (Required for All) 
Have you ever participated in any of the following activities during the 7th, 8th, 9th, or 10th grade? 

Boy/Girl Scouts:
Community Service:
Student Government:
School Club:
Science/Robotics Club:
School Newspaper:
Civil Air Patrol:
National Honor Society:
Drama Club:
JROTC Program:
Sea Cadets:
Church Group:
Part-Time Job:
Drill Team:
Debate Team:
Pilot's License:
Other (Explain in Remarks):

Did you ever hold a leadership role (officer, club president, drum major, etc.) in a non-athletic extra-curricular activity?: (Required)
Remarks or Additional Comments:
(Limited to 1000 Characters)

Personal Statement 
Please answer the following questions briefly: Why are you interested in attending USNA Summer STEM?
Have you received any STEM-related awards or been involved with any STEM-related activities, groups, conferences?:

(Limited to 1000 Characters)

Medical Conditions 
Due to the nature of the activities that take place during Naval Academy Summer STEM, the following questions should be answered in their entirety. 
Do you currently have any educational accommodation (i.e. IEP, 504 plan, or special classes, etc)?: (Required)
If you selected Yes, please explain:
(Limited to 1000 Characters)
Do you have any medical conditions (any history of asthma, heart conditions, color deficient vision, hearing impairments, etc.)?: (Required)
If you selected Yes, please explain:
(Limited to 1000 Characters)
Do you require the use of an inhaler during physical fitness?: (Required)
Do you require the use of any daily medications?: (Required)
If you selected Yes, please explain:
(Limited to 1000 Characters)
Do you have any allergies (i.e. food, nuts, medication, latex, etc.)?: (Required)
If you selected Yes, please explain:
(Limited to 1000 Characters)
Please indicate desired T-Shirt Size: (Required)
Please indicate desired Shorts Size: (Required)

By SUBMITTING this electronic application, I am accepting the following:
1.I certify that the information submitted on this application is complete and correct to the best of my knowledge. Failure to completely and honestly provide any information requested by the USNA may be grounds for withdrawal of any offer of appointment or may subsequently result in dismissal from the USNA and its summer programs.
2.If there is a change in information I have provided or has been submitted on my behalf to the USNA, I will immediately inform the Admissions Office.

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