2017 Nomination Form
Instructions: Complete all information below. Be as specific and detailed as possible. Provide as many attachments as required to assist the validation of the incident, eligibility of the nominee/team, and level of Award nomination. Statements/Affidavits should contain as much detail as the party can recall including all facts and occurrences to clearly show what manner and to what extent an extraordinary effort was made, witness names, persons rendering assistance during the incident and all pertinent circumstances and data showing the precise nature and level of competence involved. Additional information/attachments should be emailed to email@example.com.
If selected for an award, the primary point of contact (Submitting Official/Chief/Commander below) will be notified by H and L Board of Directors. It is the responsibility of the NOMINATOR to contact all other representatives.