Citizens Academy Nomination Form - Louisville

FBI Citizens Academy Nomination Form
Louisville Field Office

I am nominating the following individual as a potential candidate for participation in the FBI Citizens Academy program.

Fields marked in red are mandatory. You must enter N/A if not applicable.

Nominee Information (Candidate)

First Name:

Middle Name:

Last Name:

Mailing Address:

City:

State:

ZIP Code:

Home Phone:

Work Phone:

Cell Phone:

E-Mail Address:

Nominator Information (You)

First Name:

Middle Name:

Last Name:

Mailing Address:

City:

State:

ZIP Code:

Home Phone:

Work Phone:

Cell Phone:

E-Mail Address:

I am a(n):

FBI Employee
Citizens Academy Graduate

Describe the nature (professional/personal) and duration of your relationship with the nominee:

characters remaining

Narrative: Please provide a statement, not to exceed two paragraphs, describing the reasons you believe the nominated individual is a good candidate for the FBI Citizens Academy program. Include involvement and/or membership in any civic, religious, business, and/or community organizations highlighting the nominated individual’s contributions to the community.

characters remaining

Candidate submissions will be reviewed and selected by identified field office personnel. For questions, please contact FBI Louisville's Community Outreach Specialist at (502) 263-6147.

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Citizens Academy Nomination Form - Louisville

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