Submitting an Officer's Name

An Officer Data Form is to be submitted to the NLEOMF for each officer to be considered for inclusion on the National Law Enforcement Officers Memorial. The form must be completed by an official representative of the department for which the officer served and must be signed by the head of the agency. Otherwise, this form will not be processed.

Names are inscribed on the National Law Enforcement Officers Memorial once a year, in the spring immediately prior to National Police Week. An Officer Data Form must be submitted by the December 31 deadline to be considered for inclusion on the Memorial the following year.

We cannot accept emailed forms. Please either fax or mail them to us at the contact information below.

• Law Enforcement Agency Officer Data Form.
  
  
• Not a Law Enforcement Agency Officer Data Form. NLEOMF will contact the appropriate department.
  
   Download a free Adobe Acrobat Reader.

Fax the completed form to:

NLEOMF
Research Department
202-737-3405

Or mail to:

NLEOMF
Officer Data Form
400 7th Street, NW
Suite 300
Washington, DC 20004