You must have JavaScript enabled to use this form. Indicates required field NOMINATOR INFORMATION Name First Last Phone Number Email Does your nominee know you are nominating them for this recognition? Yes No NOMINEE INFORMATION Name First Last Phone Email Address Address City/Town State/Province - Select -AlabamaAlaskaAmerican SamoaArizonaArkansasArmed Forces (Canada, Europe, Africa, or Middle East)Armed Forces AmericasArmed Forces PacificCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFederated States of MicronesiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarshall IslandsMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPalauPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirgin IslandsVirginiaWashingtonWest VirginiaWisconsinWyomingAlbertaBritish ColumbiaManitobaNew BrunswickNewfoundland and LabradorNova ScotiaNorthwest TerritoriesNunavutOntarioPrince Edward IslandQuebecSaskatchewanYukon ZIP/Postal Code Please upload a headshot of the nominee. It is NOT required to be in uniform for the photo. Headshot One file only.200 MB limit.Allowed types: gif, jpg, jpeg, png. Nominee Branch of Service Air Force Army Coast Guard Navy Marine Corps Why are you nominating this veteran? What are the nominee’s years of service? (Please clarify if multiple tours or service in multiple branches) Please describe the nominee’s community service involvement. Please indicate the nominee’s character of military discharge (e.g., Honorable, General, etc.). Veterans of the Year honorees must have been discharged under honorable conditions. You may use this text box to elaborate if necessary. Leave this field blank
