Form 31bc Public Safety/Law & Order Individual Awards

Chapter(Required)

Operating Year(Required)

OY 2023 (July 2023 - June 2024)

Chapter Commander(Required)

Please detail the full name of the Chapter Commander. Please include Rank/Title, First, Middle, Last, Suffix, Service (Status), where possible.

Chapter Commander's Email(Required)

Confirmation will be sent to this address.

Please choose your submission type(Required)

Exceptional Public Safety / Law & Order Service Award (Individual)

Outstanding Public Safety / Law & Order Performance Award (Individual)

Please choose one award type for initial review by the committee. Please Note: The committee may feel that the submission is better suited for the other award, if so you will not need to resubmit.

Full Title & Name of Nominee(Required)

Please type the full name for the award.

Nominee's Work Address(Required)

Please be as complete as possible.

Narrative(Required)

Accepted file types: pdf, doc, docx, Max. file size: 10 MB.

Please upload a PDF or DOC with the full narrative justification for the nominee.