The following individual has been identified as a potential candidate for participation in the (FIELD OFFICE) Citizens’ Academy.


Name: _____________________________________________________________

Address: ___________________________________________________________

Telephone:    (H) ____________________________________

        (W) ____________________________________

Email Address: ___________________________________________________


Name of Employer/Business/Organization: ___________________________________

Address: _____________________________________________________________

Title/Position: ____________________________________


NARRATIVE

Below, please describe the reasons you believe this person is a good candidate for the FBI Citizens’ Academy. Include their involvement or membership in any civic, business, religious, and/or community organizations which may demonstrate their desire to improve life in our community. Attach your narrative to this form.


Name of Nominator (Please print): ________________________________________

Signature of Nominator: _________________________________________________