Individual award application w supplemental app doc 2025

1. Click ‘Get Form’ to open the individual award application in the editor.
2. Begin by filling out the Nominee Information section. Enter the nominee's name, address, email, phone number, EMS agency affiliation, rank, position, and title. If applicable, include the EMT level and certification number.
3. Select the award for which the nominee is being considered by checking the appropriate box. Options include Medal of Valor, EMS Cross, Distinguished Service Medal, among others.
4. Complete the Nominated by section with your information as the nominator. Include your name, address, email, phone number, EMS agency affiliation, rank, position, and title. If you are an EMT, provide your level and certification number.
5. Describe your relationship to the nominee in the designated field.
6. Sign and date the form to certify that all information provided is accurate to your knowledge.
7. For supplemental information, succinctly describe the basis for nomination in Section 1. Use additional paper if necessary.
8. Attach any supporting documentation that substantiates your nomination in Section 2. Ensure each piece is labeled with both nominee’s and nominator’s names.

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