Nomination For

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					                                        2012
                OUTSTANDING SERVICE TO VETERANS
                      AWARD NOMINATION
This is an equal opportunity award open to all who meet the criteria. Nominations may be
submitted by any person, organization, or institution.
Nominee’s Information:
Name:                                            Phone #:

Address:




Date of Entry into Military Service:                     Date of Discharge:

Type of Discharge:                                       Branch of Service:


Person/Organization submitting nomination (if more than one, list on back)

Name:                                            Phone #:

Address:




The nominee will be judged in one of the following categories.
Please check the box next to the category you want the nominee to be considered in. You
may check more than one.

     Outstanding Veteran Volunteer for service to veterans.
     Outstanding Volunteer Service Officer for service to veterans.
     Outstanding Service Officer for service to veterans.
     Outstanding Employee for service to veterans.
     Outstanding Male Non-Veteran for service to veterans.
     Outstanding Female Non-Veteran for service to veterans.
     Outstanding Patriotic Service Award

              Nominations must be postmarked no later than September 10, 2012

                        Submit nominations to lisan@dva.wa.gov or
              WDVA Attn: Liza Narciso, P.O. Box 41150, Olympia, WA 98504-1150.
List the nominee's achievements, activities, and contributions to assist veterans and their
families, to include involvement and contributions to community, state or national efforts.

				
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