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:
• Answers to questions 1-3 should be typed on separate 8 1 / 2 x 11 pages and attached to the nomination form.
• The incident / meritorious act described in this nomination form must have occurred between January 1st and December 31st
• The award is open to all law enforcement officers in the State, regardless of rank.
• The recipient of the award may be living or deceased.
• The recipient will receive a medal at the NJSACOP Annual Conference held in June in Atlantic City, New Jersey.
• Nomination forms will be published in The New Jersey Police Chief Magazine and on the NJSACOP website.
• Incomplete nomination forms will not be considered.
Signature: Date:
Please send nomination forms to:
New Jersey Police Chiefs Foundation Valor Awards Program 751 Route 73 North Suite 12 Marlton, New Jersey 08053 office @ njsacop. org