THE NINTH ANNUAL TOP COPS Awards^® Nomination Form - PRINT OUT THIS FORM -  

Requirements: All nominations must meet the following provisions in order to be considered.

• Nominee(s) must be a sworn law enforcement officer from any federal, state, county or local law enforcement agency within the United States.
• Nomination must be submitted by a sworn law enforcement officer, who must provide their signature in the space designated below.
• Nomination must involve an incident occurring between January 1, 2001 and December 31, 2001.
  

Instructions:

Please write a short essay on why your nominee should be considered for a 2002 TOP COPS Award^®. This essay should be composed on a separate sheet of paper and should be no longer than 500 words. Remember to be as specific as possible with references to dates, events etc. In addition, you will need to complete the areas below and attach this form to your essay. We invite you to send additional information in support of your nominee: Newspaper articles, police reports and video tapes all help our judges in their decision making process. Kindly send your package, postmarked no later than April 15, 2002, to:

Nominee:

Title:___________________________________________________________________

Full Name:______________________________________________________________

Department:_____________________________________________________________

Precinct Street Address:____________________________________________________

City, State & Zip:_________________________________________________________

Telephone (W):__________________________________________________________

Telephone (H):___________________________________________________________

Fax Number:_____________________________________________________________

Nominating Officer:

Title:___________________________________________________________________

Full Name:______________________________________________________________

Department:_____________________________________________________________

Street Address:___________________________________________________________

City, State & Zip:_________________________________________________________

Telephone (W):__________________________________________________________

Telephone (H):___________________________________________________________

Fax Number:_____________________________________________________________  

Signature:_____________________________________________________________  

Signature:_____________________________________________________________