ACCPD Commendation Form

2. First Name*

3. Last Name*

4. Cell Phone Number

5. Home Phone Number

7. E-mail Address*

8. Do you wish to remain anonymous?

   1. Yes
   2. No

10. Address 1

12. Address 2

14. City

15. State

16. Zip

20. Date of contact with employee
    Date of contact with employee

    Date of contact with employee

21. Location of interaction

22. Case Number (if applicable)

24. Employee Name / Badge #

25. 2nd Employee Name / Badge #

26. 3rd Employee Name / Badge #

28. Car Number (if known)

30. Commendation Remarks*

    Use this field to provide details about your commendation

32. This form may be printed out and delivered or mailed to the Athens-Clarke County Police Headquarters (3035 Lexington Road, Athens GA 30605), emailed to police@accgov.com or submitted directly through this website form.

    This form may be printed out and delivered or mailed to the Athens-Clarke County Police Headquarters (3035 Lexington Road, Athens GA 30605), emailed to police@accgov.com or submitted directly through this website form.

Leave This Blank:


33. 1. Receive an email copy of this form.
34. Email address

    This field is not part of the form submission.

35. Submit

* indicates a required field