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Create a Reference

Let’s get started! Enter your First Name and Last Name below, along with a brief description of how you know the person you are creating a reference for.

Your First Name:

Your Last Name:

Status-Please Select- Career (Fed/State/Local) Career (Private) Considering Joining Hospital Manufacturer / Distributor Military Other Paid on call Recruit Retired / Former Supporter / Enthusiast Trade / Professional Organizaton Volunteer

Service-Please Select- Assistant / Deputy Chief Auxiliary Battalion Chief Captain Civilian Dispatcher District Chief Fire Chief Fire Department Employee Fire Inspector Fire Marshal Firefighter / Company Officer Forest Ranger / Warden Industry Representative Law Enforcement Lieutenant Medic / Corpsman Nurse Other Paramedic / EMT Physician Pilot Recruit / Cadet Student Survivor Trainer / Instructor

Confirm Relationship History

Who was your employer while you worked with Michael Kiriakou?

What was your position at that company?

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