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Public Service and Heroism Award Reporting

Form Description: 

Use this form to report the awarding of the following medals:

Law Enforcement Commendation
Fire Saftey Commendation
EMS Commendation
or Heroism Award

A PDF version of the form can be downloaded, printed out, and mailed in if you like.  You can find that form in the "Forms" section of the NSSAR Website.

Reports that are made before June 1 will be included in the Public Service Awards Booklet at the NSSAR Congress for that year.

Use this form to report the awarding of the following medals: Law Enforcement Commendation Fire Saftey Commendation EMS Commendation or Heroism Award.
Award Info
Please select the award that was given (select one)
To whom was the award given (First Middle Last)
Please list the rank or title of the individual that received the award
List the Agency the Individual works for
Where was the award presented
Was there media coverage / publicity for the presentation
Provide a brief description of the outstanding contribution(s) and / or accomplishment(s)
Name of the Chapter of State Society that made the presentation
Submitted By Info
This form was filled out by: (First Middle Last)
Please provide your National Number
Your email address
Your postal mailing address