Online Application Form

FBI National Citizens Academy Alumni Association

APPLICATION FOR CHAPTER MEMBERSHIP

First name

Last name

FBINCAAA Chapter

Field Office Where you Attended FBI Citizens Academy Program

Year Graduated

Address

Phone (Add country code 1)

Alternative Phone

Email

Business Information

Employer

Occupation

Address

City

State

Zip Code

Emergency Contact

Name

Relationship

Phone (Add country code 1)

Email

SECTION TWO: INTERESTS, EXPERTISE AND CAPABILITIES

FBI National Citizens Academy Alumni Association is a nonprofit organization separate and apart from the FBI

SECTION THREE: PERMISSIONS (Check All That Apply)

I want to receive email communications from the Chapter regarding programs, events, volunteer opportunities, reminders, and other news and announcements. I understand that members may opt out upon request.

I want to receive email communications from FBI National Citizens Academy Alumni Association regarding education programs, conferences, policies, resources, and messages from FBI Headquarters. Members may opt out upon request. If yes, please complete the attached Communication Consent Form and return it to the Chapter’s Membership Director to sign and return the form to FBI National CAAA.

I grant permission to publish my name and contact information in the Chapter Membership Directory, and understand that the information is restricted for use only by Chapter members and the FBI Field Office. Members can ask to be removed from the directory at any time.

SECTION FOUR: ACKNOWLEDGEMENTS

I am a graduate in good standing of the FBI Citizens Academy Program, and will act only in the best interests of the FBI and FBI National CAAA and its Affiliate Chapters.

I understand that chapter membership is granted only to individuals who meet and maintain the guiding principles for FBI Citizens Academy Graduates as well as the FBINCAAA Program Requirements. I am committed to adhering to these standards along with the Chapter’s Bylaws and other policies.

I will at all times maintain compliance with all applicable FBI security requirements in the sole and absolute discretion of the FBI (FBI Requirements). Failure to maintain such certification will immediately disqualify an individual from FBINCAAA chapter membership, including all service as an officer, director, or member of a team. The undersigned hereby consents that the FBI may communicate the status of my compliance or non-compliance with the FBI and FBI National CAAA.

Conflict of Interest

I will make known any relationships, transactions, or other circumstances that could create a conflict of interest, now or in the future, between the CAAA and personal interests.

No conflict of interest to declare.

I have the following relationships, transactions or positions that could create a conflict of interest, or an appearance of a conflict of interest (describe):

Signature (do not type signature)

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I agree that my electronic signature is the legal equivalent of my manual/handwritten signature on this document.

Date picker

TO BE COMPLETED BY THE CHAPTER MEMBERSHIP DIRECTOR

I have verified that the applicant is an FBI Citizens Academy graduate in good standing.

Application approved

Dues paid

Membership Director/Coordinator Signature (or Other Designated Director):

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Date

Month

Day

Year

IMPORTANT: Upon acceptance, please update the Chapter’s membership database. Upload the member application and update the membership roster in BoardEffect. Send the signed Communications Consent Form to support@fbincaaa.org.