Nomination Form

Each year, the NVFC honors a volunteer firefighter for exemplary performance. This prestigious national award affords the recipient with a place in history with the NVFC. The award is sponsored by Scott Health & Safety.

The following conditions should be considered when submitting a candidate?s nomination. Individuals selected must have given outstanding service to his or her state or state association in the fire service. This award is not an award for heroism.

Applicants should also submit a resume and letters of recommendations.

Nomination Form
Deadline August 1, 2008

Name of Nominee
Address
City, State, Zip
Phone/Fax
Fire Service History
Department, City, State
Date Joined
Elected Positions Held
Appointed Positions Held
Other Pertinent Department Information
Association History
State Level Service
Local/County Level Service
Other Pertinent Information
Family History
Wife/Husband
Children
Relatives/Siblings also in fire service

Other Information
Other Service to Community/State Government
Council/Board/Commissions/Legislative Service
Number of years in the fire service and/or fire prevention
Religious Positions
Past Honorary Awards Received
Additional Comments
Name of individual filling out this form
Address of individual filling out this form
Phone number of individual filling out this form

Awards

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