National Awards Nomination Form

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VVA NATIONAL AWARDS NOMINATION FORM

CHECK ONE:

Member of the Year	Chapter of the Year
Incarcerated Member of the Year	Chapter Newsletter of the Year (200 members or more)
AVVA Member of the Year	Chapter Newsletter of the Year (199 members or less)
State Council of the Year	E-Newsletter of the Year
	State Council Newspaper of the Year

Complete this form in full and include all required signatures, information, and materials as listed in the criteria for each award category. All information is necessary for your nomination to be considered. You may make more than one nomination, but please use a separate form for each nomination you submit. Print this form out and mail to: Vietnam Veterans of America, Attn: Awards Committee, 8605 Cameron Street, Ste. 400, Silver Spring, MD 20910. NOMINATIONS MUST BE POSTMARKED by June 1, 2009.

YOUR NAME

DATE

YOUR STREET ADDRESS

CITY

STATE

ZIP

YOUR PHONE NO.

FAX NO.

YOUR CHAPTER OR STATE COUNCIL

NOMINEE'S NAME (individual, chapter, etc.)

NOMINEE'S REPRESENTATIVE (if nominee is an affiliate)

ADDRESS OF NOMINEE / REPRESENTATIVE

NOMINEE / REPRESENTATIVE PHONE NO.

YOUR SIGNATURE

*OTHER REQUIRED SIGNATURES

* see National Awards Criteria