Online Application (OA)

United States Coast Guard Academy Introduction Mission Program Application and Supplemental Forms

1625-NEW_AIM_Application_Online_r2

Online Application (OA)

OMB: 1625-0121

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Welcome to the United States Coast Guard Academy Introduction Mission (AIM) Program
Application!
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you to create a unique username and password. Even if you already have an AY account
that you've used to apply to another institution, you'll need to create a new one using the
"create account" button (on the right) before you can access our applications. This new AY
account allows you to save your progress on our applications, so that you can return to
work on your applications over several sessions and transmit your information to us
through a secure server. If you previously created an AY account to apply to our AIM
Program, you can and should use that account to apply to the Class of 2018.
Please carefully read all instructions that appear throughout our applications. You can only
submit an application once, so updates will need to be provided to the Admissions Office
via e-mail for inclusion in your record. By accessing our applications, you are confirming
that you have read and understand our Privacy Act Statement. All information submitted to
USCGA, including your personal statements, is protected under the Privacy Act.

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Privacy Act Statement: In accordance with 5 USC 552(e)(3), the following information is
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provided to you when supplying personal information to the USCG: (1) Authority which
below to register for a new
authorizes the solicitation of the information: 14 USC 182(a); (2) The Principal Purpose for
account.
this information is to ensure that the applicant is basically qualified to apply for the USCGA
or AIM Program; (3) Routine uses which may be made of the information: a) As
background information on applicants for the selection process; b) To contact the
applicant; c) The social security number may be used as a unique identifier; d) To
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determine if there are existing USCG records on the applicant; and e) In performance of
the duties of officials and employees of the USCG, in managing and contributing to the
Security Information
USCGA or AIM Program selection process and tendering appointments to the same; (4)
Disclosure of the information is voluntary, but the applicant will not be considered further if
the information is not provided. Submissions of Evaluators will not be disclosed to the
applicant without Evaluator consent. Release to any other individual/entity is only as
required by law.
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valid OMB control number. The Coast Guard estimates that the average burden for this
form is 180 minutes. You may submit comments concerning the accuracy of this estimate
or any suggestions for reducing the burden to [email protected].

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Status Legend
Not Started

Class of 2017
Application Deadlines

Started
Early Action, Group 1:
October 15th
Early Action, Group 2:
November 15th
Regular Admissions:
February 1st

USCGA 2017 Application

Submitted

Submission Status: Not Submitted
AIM Program Application
Submission Status: Not Submitted

Notification Dates
Early Action, Group 1:
By December 24th
Early Action, Group 2:
By February 1st
Regular Admissions:
By April 15th

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Welcome, Chris! Your application is in progress.
USCGA AIM Application
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Details

Chris McMunn
Thank you for your interest in the United States Coast Guard
User Name: mcmunn1
Academy and the AIM Program. This application must be
completed online and submitted electronically. You do not have
to complete your application in one sitting - you may save your
AIM Program Application
progress and return to work on your application until it is ready to
submit. You can quickly switch between sections of the
Submission Status:
application by using the navigational links located on the left side
Not Submitted
of the screen.
If possible, consider completing the "Recommendations" section
first to allow those individuals to begin working on your letters of
recommendation while you are working on your application.
Once you have completed your application, use the "Submit"
button located at the top of the page to begin the process of
electronically sending your application to our office.
Please note that you can only submit your application once
and, once submitted, you will not be able to make changes
to your application using the online system; however, you
may submit corrections via e-mail.

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Applicant Information
Family Information
Educational Information
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Applicant Information
* Indicates a required field

Name and Social Security Number
Legal First Name *
Legal Middle Name

Recommendations

Legal Last Name *

Check Your Application
Suffix



Social Security Number *
###-##-####

Mailing Address
Address Line 1 *
Address Line 2
City *
State



Select One
Required if living in the U.S.

Country *

Select One



Zip or Postal Code *
#####

Telephone Numbers and Email
Primary Phone Number
(###) ###-####

Alternate Phone Number
(###) ###-####

International Phone Number
Email Address *
We will occasionally send official correspondence only via email, so please
ensure you're providing us an address you will maintain and check at least
once a week.

Personal Information
Height *

Inches

Weight *

Pounds

Date of Birth *
(mm/dd/yyyy)
You must be 16-17 years old to attend the AIM Program

City of Birth *
County of Birth
Required if born in the U.S.

State of Birth



Select One
Required if born in the U.S.

Country of Birth *

Select One



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Gender *

Select One 

Marital Status *

Select One

Citizenship *

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

Select One

If you hold dual citizenship, please choose the other country below.

Other Country of Citizenship
Are you fluent in another
language? *



Select One

 Yes 




 No




If you are fluent (reading, speaking, and writing) in a language other than
English, enter the other language below.

Other Language(s)
Are you of Hispanic or Latino
ethnicity or heritage? *

Select One



Regardless of your answer to the previous question, please select all of the races which best describe
you. *

 African-American or Black (including Africa and the Caribbean)




 Asian (including Indian subcontinent and the Philippines)




 Native American or Alaska Native (including all original peoples




of the Americas)
 Native Hawaiian or Pacific Islander (original peoples)




 White (including Middle Eastern)




 Decline to answer




Have you ever been detained, arrested, summoned into court or participated in a diversion or probation
program? *

 Yes 




 No




If yes, please briefly explain.




Characters left in your response 300

Do you have any tattoos,
brandings, or body piercings? *

 Yes 




 No





If yes, please briefly describe.




Characters left in your response 300

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Applicant Information
Family Information
Educational Information
Extracurricular Information
Additional Information
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Family Information
* Indicates a required field

Mother's Information
Is she living? *

Recommendations

Mother's First Name

Check Your Application

Mother's Last Name

 Yes 




 No





Work Phone
(###) ###-####

Home Phone
(###) ###-####

International Phone Number
Email Address
Occupation
Is your mother a graduate of one
of the federal service academies?
*
Did your mother graduate from
college? *



Select One

 Yes 




 No





College(s) attended (if any)
Highest Education Level

Select One

Was or is your mother a member
of the armed forces? *

Select One

Highest Rank Held

Select One 




Mother's Address
Does your mother have a
different mailing address than
you?

 Yes 




 No





Mailing Address
City
State



Select One
Required if living in the U.S.

Country

Select One



Zip or Postal Code
#####

Father's Information
Is he living? *

 Yes 




 No





Father's First Name
Father's Last Name

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Work Phone
(###) ###-####

Home Phone
(###) ###-####

International Phone Number
Email Address
Occupation
Is your father a graduate of one
of the federal service academies?
*
Did your father graduate from
college? *



Select One

 Yes 




 No





College(s) attended (if any)
Highest Education Level

Select One

Was or is your father a member
of the armed forces? *

Select One

Highest Rank Held

Select One 




Father's Address
Does your father have a different
mailing address than you?

 Yes 




 No





Mailing Address
City
State



Select One
Required if living in the U.S.

Country



Select One

Zip or Postal Code
#####

Other Information
Parents' Marital Status

Select One 

If you answered other, please
explain
If not with both parents, with
whom do you reside?
Do you have siblings?

 Yes 




 No




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Educational Information
* Indicates a required field

Current High School
Type of School *

Select One 

Recommendations

If you are a home school student, and you cannot locate your program using the "Look up" system,
please enter 777771 for the CEEB code.

Check Your Application

CEEB Code *

Look up

School Name *
School Address *
City *
State
Country
Zip or Postal Code *
#####

Telephone Number*
(###) ###-####

Attended From *
mm/yyyy

Graduation Date *
mm/yyyy

Have you attended
another high school? *

 Yes 




 No





Previous High School
Type of School

Select One 

If you are a home school student, and you cannot locate your program using the "Look up" system,
please enter 777771 for the CEEB code.
CEEB Code

Look up

School Name
School Address
City
State
Country
Zip or Postal Code
#####

Telephone Number
(###) ###-####

Attended From
mm/yyyy

Attended To

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mm/yyyy

Colleges and Universities
College Code

Look up

College/University Name
City
State
Zip or Postal Code
#####

Attended From
mm/yyyy

Attended To
mm/yyyy

Anticipated Senior Courses
Please list the courses you are planning to take during your senior year in high school or at
college. You may enter up to eight courses.
Course Name 1
Course Name 2
Course Name 3
Course Name 4
Course Name 5
Course Name 6
Course Name 7
Course Name 8

Academic Information
What is your intended
major? *
Are you a member of the
National Honor Society? *

Select One



 Yes 




 No





Briefly list any academic
honors you received while
in high school or college.




Characters left in your response 300

Have you taken either the
SAT or ACT exam? *

 Yes 




 No





Will you or did you receive any special accommodations - such as extended or unlimited time - when
taking the SAT Reasoning or ACT exam? *

 Yes 




 No




If yes, please briefly
explain.




Characters left in your response 300

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Standardized Test Scores
SAT Critical Reading
Score
SAT Math Score
SAT Writing Score
ACT English Score
ACT Math Score
ACT Writing Score

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Extracurricular Information
* Indicates a required field

Activity 1
Please list the three most meaningful extracurricular activities that you have participated in.
Activity*

Select One



If other, please list activity.
Grade Level Participated*

9




 10




 11





Varsity Letter

9




 10




 11





Team Captain

9




 10




 11





Leadership Position

9




 10




 11





Achievements
If offered, I plan to participate in
this activity at the Academy*

 Yes 




 No





Coach/Advisor Name*
Coach/Advisor Telephone
Number*

(###) ###-####

Activity 2
Activity

Select One



If other, please list activity.
Grade Level Participated

9




 10




 11





Varsity Letter

9




 10




 11





Team Captain

9




 10





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Page 2 of 5

 11




Leadership Position

9




 10




 11





Achievements
If offered, I plan to participate in
this activity at the Academy

 Yes 




 No




Coach/Advisor Name
Coach/Advisor Telephone
Number

(###) ###-####

Activity 3
Activity

Select One



If other, please list activity.
Grade Level Participated

9




 10




 11





Varsity Letter

9




 10




 11





Team Captain

9




 10




 11





Leadership Position

9




 10




 11





Achievements
If offered, I plan to participate in
this activity at the Academy

 Yes 




 No




Coach/Advisor Name
Coach/Advisor Telephone
Number

(###) ###-####

Activity 4
Please list up to three additional extracurricular activites you'd like us to know about.
Activity

Select One



If other, please list activity.
Grade Level Participated

9




 10




 11





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Varsity Letter

Page 3 of 5

9




 10




 11





Team Captain

9




 10




 11





Leadership Position

9




 10




 11





Achievements
If offered, I plan to participate in
this activity at the Academy

 Yes 




 No




Coach/Advisor Name
Coach/Advisor Telephone
Number

(###) ###-####

Activity 5
Activity

Select One



If other, please list activity.
Grade Level Participated

9




 10




 11





Varsity Letter

9




 10




 11





Team Captain

9




 10




 11





Leadership Position

9




 10




 11





Achievements
If offered, I plan to participate in
this activity at the Academy

 Yes 




 No




Coach/Advisor Name
Coach/Advisor Telephone
Number

(###) ###-####

Activity 6
Activity

Select One



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United States Coast Guard Academy | Chris McMunn

Page 4 of 5

If other, please list activity.
Grade Level Participated

9




 10




 11





Varsity Letter

9




 10




 11





Team Captain

9




 10




 11





Leadership Position

9




 10




 11





Achievements
If offered, I plan to participate in
this activity at the Academy

 Yes 




 No




Coach/Advisor Name
Coach/Advisor Telephone
Number

(###) ###-####

Work Experience
List up to two jobs you have held during the past three years.
Specific nature of work
Employer
Employed From
mm/yyyy

Employed To
mm/yyyy

Approximate number of hours
worked per week
Employer Telephone Number
(###) ###-####

Work Experience 2
Specific nature of work
Employer
Employed From
mm/yyyy

Employed To
mm/yyyy

Approximate number of hours
worked per week
Employer Telephone Number
(###) ###-####

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Main

USCGA AIM Application
Applicant Information
Family Information
Educational Information
Extracurricular Information
Additional Information
Personal Statements

Recommendations
Check Your Application

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Additional Information
* Indicates a required field

Preferred AIM Sessions
If you are only available for one session, please list it as both your first and second choice.
First Choice *

Select One



Second Choice*

Select One



Not Available
July 1-7 2012
July 8-14 2012
July 15-21 2012
Select all that apply

Medical Information
Are you currently taking
medication for ADHD/ADD,
asthma, or diabetes? *

 Yes 




 No




Is your vision in either eye not
correctable to 20/20 or are you
colorblind? *

 Yes 




 No




Do you have any allergies that
have resulted in respiratory
problems or have you ever
passed out or had severe chest
pain from exercising? *
Have you had knee or shoulder
surgery since July 2011? *

 Yes 




 No




 Yes 




 No




If you answered yes to any of
these questions, please briefly
explain.




Characters left in your response 500

USCGA Information
How did you first learn about the
Coast Guard Academy? *
Detailed Source *

Select One





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Main

USCGA AIM Application
Applicant Information
Family Information
Educational Information
Extracurricular Information
Additional Information
Personal Statements

We require your guidance counselor, or an appropriate school
official, to submit an official high school transcript along with a
letter of recommendation. In addition, you may request up to two
optional letters of recommendation from any source.
Individuals submitting letters of recommendation for your AIM
application must submit them electronically through the online
system to ensure they are added to your record.

Recommendation Provider List
Recommendations
Check Your Application

A recommendation provider is an individual who will complete
and submit a recommendation form on your behalf.
How the online recommendation process works:







Click the "Recommendation Provider List" button above.
Insert the name and contact information of each
recommendation provider.
Once the recommendation provider information is saved,
an email will be sent to the online recommendation
provider with an access code and instructions on how to
proceed with the online recommendation.
When the recommendation provider submits the form to
our office it will become a part of your application.
You can view the status of your online recommendations
each time you log into your application account.
Application Home

Technical Support

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Additional Information
Your Recommendations will
automatically be matched to
your application upon
submission.
The access code is valid for 180
days from the date you input
and save their information.
To complete the
Recommendation online, a
Recommendation provider must
have a valid email address.
If you would like to send a
reminder, check the box next to
his/her name and click on the
"resend" button. This will
automatically generate a
reminder email.

Update Profile

Logout

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USCGA AIM Application
Applicant Information
Family Information
Educational Information
Extracurricular Information
Additional Information
Personal Statements

Logout

We require your guidance counselor, or an appropriate school official, to submit an official high
school transcript along with a letter of recommendation. In addition, you may request up to two
optional letters of recommendation from any source.
The individual submitting your official high school transcript must submit it electronically through the
online system to ensure it is added to your record. Your application will not be considered
complete, and therefore will not be reviewed, until your high school transcript is received via
the online system.

Recommendation Provider
Recommendations

Recommendation Provider

Status

Check Your Application

No Recommendation Providers have been entered yet. Click the button below to
identify one of your Recommendation Providers.

Please note that notification emails will indicate "United States Coast Guard
Academy" as the sender but will come from [email protected]. If they use
a spam-blocking tool, please ask them to add this email address to their list of
known/safe addresses.
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Please Complete the Following

USCGA AIM Application
Applicant Information
Family Information
Educational Information
Extracurricular Information
Additional Information
Personal Statements

Logout

Recommender First Name:*
Recommender Last Name:*
Street Address (Line 1):
Street Address (Line 2):
City:
Postal Code:

Check Your Application

Country:



-- Select --

State:
Recommendations

-- Select --



Phone:*
(###) ###-#### for a U.S. number
Email Address:*
Title:
Employer:
Relationship to you:*

-- Select -
Application cannot be submitted until a recommendation provider
has been added with Role of English Instructor, Guidance
Counselor, Math Instructor, and PFE Administrator

We require all applicants submit an official high school transcript. Will this recommender be
providing one along with their letter of recommendation?*

 Yes




 No





Do you wish to waive your right to examine this letter of recommendation?*

 Yes




 No




Under the Family Educational Rights and Privacy Act of 1974, students have access to their
education record, including letters of recommendation. However, students may waive their
right to see letters of evaluation, in which case the letters will be held in confidence.

* indicates a required field
If you would like to include a personal note in the notification email that is delivered, please use
the space below:




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File Typeapplication/pdf
File Titlehttps://previewapp.applyyourself.com/AYApplicantLogin/Applicant
Authorcmcmunn
File Modified2014-07-25
File Created2012-12-10

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