The NJ Police Chief Magazine - Volume 32, Number 4 | Page 30

CONTACT INFORMATION FOR PERSON SUBMITTING NOMINATION FORM:
Name:
Department / Agency / Organization:
Address:
City / State / Zip:
Phone: E-mail:
Relationship to Nominee:
NOMINEE INFORMATION:
Name:
Title / Rank:
Department:
Address:
City / State / Zip:
Date( s) of Exceptional Act( s):
1.
Please give a brief history of the nominee.
2.
Describe the event or circumstance for which you feel the nominee displayed unparalleled courage and valor and is deserving of the New Jersey
Police Chiefs Foundation Valor Award.
3.
Describe in detail why you feel the nominee went above and beyond the call of duty during this event.
IMPORTANT DETAILS:
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Answers to questions 1-3 should be typed on separate 8 1 / 2 x 11 pages and attached to the nomination form.
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The incident / meritorious act described in this nomination form must have occurred between January 1st and December 31st
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The award is open to all law enforcement officers in the State, regardless of rank.
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The recipient of the award may be living or deceased.
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The recipient will receive a medal at the NJSACOP Annual Conference held in June in Atlantic City, New Jersey.
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Nomination forms will be published in The New Jersey Police Chief Magazine and on the NJSACOP website.
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Incomplete nomination forms will not be considered.
Signature: ___________________________________________________________________________ Date: _______________________________
Please send nomination forms to:
New Jersey Police Chiefs Foundation Valor Awards Program 751 Route 73North Suite 12 Marlton, New Jersey08053 office @ njsacop. org
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