Vietnam Veterans of America
 Commendation Medal
Nomination Form

 

Name Membership Number
 
Mailing Address
 
City State Zip Phone Number
 
Chapter / State Council
 
Section I  State why you feel this individual qualifies for VVA Commendation Medal (use additional sheets if necessary)

 

 
Section II Offices and/or Committees individual served on (use additional sheets if necessary)

 

 
Section III State Council / Chapter / Civic or other awards and/or recognitions earned (use additional sheets if necessary)

 

 

SECTION II
Submitted By Membership Number
 
Check One:

Chapter President, Chapter #_______

State Council President, State of _______

Executive Board, (Chapter or State Council)
 

Address State Zip
 
 

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SIGNATURE OF OFFICER                                                   DATE