Kentucky Colonel Commission

Nominee Information

*Nominations require a minimum of 30 days for processing.

* First Name:

Middle Name or Initial:

* Last Name:

Suffix:

* Date of Birth:

Ex: MM/DD/YYYY (must be 18 years of age or older)

International Address:

Yes

* Address Line 1:

Address Line 2:

* City:

* State:

* International Address:

PLEASE NOTE: Due to mailing costs, we can only send Kentucky Colonel certificates to addresses within the United States. If a nominee is located outside the United States, we will send the certificate to the nominator. If both the nominee and the nominator are located outside the United States, please provide an alternate address within the United States for mailing. The block for entering an alternate address can be found near the bottom of the application form.

* Zip Code:

* Phone Number:

Ex: 555-555-5555 (Must be in this format)

* Tel:

Ex: 555-555-5555 (Must be in this format)

* Email Address:

Ex: example@kentucky.gov

* Profession:

* Please list any active or previous service in a charitable organization or community service and/or any military service:

* Reason for Recommendation:

Recommended By:

* First Name:

Middle Name or Initial:

* Last Name:

International Address:

Yes

* Address Line 1:

Address Line 2:

* City:

* State:

* International Address:

* Zip Code:

* Phone Number:

Ex: 555-555-5555 (Must be in this format)

* Tel:

Ex: 555-555-5555 (Must be in this format)

* Email Address:

Ex: example@kentucky.gov

* Profession:

* If issued, the commission will be mailed to (please check one):

Recommender

Recipient

Alternate Mailing Address

Alternate Mailing Address:

If both the nominee and the nominator are located outside the United States, please provide an alternate address within the United States for mailing.

* Is the commission for a presentation ceremony, or a gift?

Yes

* Date of presentation:

Ex: MM/DD/YYYY

I have proofread and verify that the information above is correct.

I acknowledge that requests will take a minimum of 30 days to process.

Security

NOTE: The Honorable Order of Kentucky Colonels is an independent, nonprofit organization. For more information, call 502-266-6114 or visit https://www.kycolonels.org.

Please print this page before submitting the form if you would like a copy of your request.

Kentucky Colonel Commission Application

Nominee Information