2020 Veteran and Military Service Awards for 76th Assembly District

Nomination Submission Form

In recognition of the extraordinary volunteerism of our military service members and veterans in North County, we are calling for nominations to spotlight the efforts of our military community in the 76^th Assembly District. Nominees must reside or work in the 76^th Assembly District, which includes the cities of Encinitas, Carlsbad, Oceanside, Vista, Camp Pendleton, and some surrounding unincorporated areas.

Please fill out this form if you would like to submit a nomination for a military service member or Veteran who in 2020 has positively impacted the communities and neighborhoods in the 76th Assembly District. Nominations will be accepted until October 23^rd.

You can also download, print, and mail a copy of this submission form to my district office, located at 325 Carlsbad Village Drive, Suite A-2, Carlsbad, CA 92008. For questions about the nomination process, please call (760) 434-7605 or email District Director Janet Chin at Janet.Chin@asm.ca.gov for more details.

Veteran & Military Service Awards Nomination Form (PDF)

Nominee

Full Name: *

Rank/ Branch of Service:

Phone: *

Email:

Residential Address:

City: *

Zip Code:

If not a resident of 76th District

Work Address:

City:

Zip Code:

Please choose and place a check mark next to the award that you are nominating the individual for. (You may choose no more than two.)

Distinguished Veteran Volunteer of the Year

Military Spouse of the Year

Excellence in Mentorship

Excellence in Advocacy

Excellence in Entrepreneurship

Excellence in the Arts

Excellence in Service (California National Guard)

Youth Leader Achievement Award (ROTC)

Please provide a brief description of the nominee's accomplishments and why you feel they should be recognized. In your response, please detail how the individual, through their volunteerism, has positively impacted the communities in which they serve. (500 words or less). *

If you would like to provide articles, press releases, newsletter features, website links, or any other documents or media that supplement your nomination of this individual, you may send those to Assemblymember.BoernerHorvath@asm.ca.gov with the subject line "VMSA 2020"

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