Michael J. Kelly Award

Name of Nominee:*

First

Last

Title

Nominee's Work Address:*

Address City State Zip

Nominee's E-mail:*

Nominee's Work Phone:*

Nomination Submitted By (Your Name):*

Nominator's Organization:*

Nominators Address

Street Address City State / Province / Region Postal / Zip Code

Nominator's Email:*

Nominator's Phone:*

Date Submitted:*

Statement describing specifically, the innovative and creative policing practices or activities the nominee has instituted that exemplify the vision, mission, goals, and values of the Ohio Association of Chiefs of Police. Describe how this nominee’s efforts have resulted in “Vision Becoming Reality.” Please include any supporting material such as newspaper clippings, publications, other print, or other support material that serve to reinforce your nomination. *