Nominations Form 2013

Page 1

Salu ng Service Event May 21, 2013 FIRST CLASS PATRIOT ACHIEVEMENT AWARD NOMINATION FORM The Financial Planning Associa on of Pi sburgh is, once again, honoring Western Pennsylvania veterans of any US Military Branch who have demonstrated outstanding community service (currently or previously). All Nominees will be honored at Salu ng Service, a free public event on May 21, 2013. A $10,000 dona on to Veteran Place of Washington Boulevard will be made in honor of the recipient.

ABOUT THE NOMINEE Last

First

M.I.

Phone

Street Address

Apartment/ Unit #

E‐mail Address

State

Rank

ZIP

Unit

Military Service Branch

Army

Navy

Air Force

Marines

Coast Guard

Reservist

National Guard

NOMINATED BY: Last

First

M.I.

Street Address

Apt./Unit #

E‐mail Address

State

Zip

Phone Rela onship / Connec on to nominee Please check the boxes that pertain to you:

Veteran of US Military

Currently in the Military

Member of Financial Planning Associa on Do you work with a financial advisor who is a member of the Financial Planning Associa on?

Nomina on submission must include: All the informa on requested above either reproduced in type OR neatly printed by hand or submi ed on‐line. All Nominators must submit a photo of the Nominee.

DEADLINE: ▪ Midnight Sunday, March 31, 2013 : postal mail: FPA of Pi sburgh, PO Box 97795, Pi sburgh, PA 15227 e‐mail: fpa.pi sburgh@verizon.net fax: 412‐653‐1059 on‐line submission: www.fpapi sburgh.org


ABOUT THE NOMINEE Please note dates and details as appropriate; a ach more text in addi onal page/document if needed.

Please list the nominees Military honors and/or commenda ons.

Please list the nominees civilian awards or decora ons.

List outstanding community service through ac vi es & projects

Please list the characteris cs that make the nominee an outstanding ci zen.

Please share an anecdote of how this nominee exemplifies a First Class Patriot.

How does this nominee con nue to serve veterans and/or the community at large?

How does the nominee set an example for other Veterans?

All Nominees will be honored at Salu ng Service Tuesday, May 21, 2013 at Soldiers and Sailors Memorial Hall, Oakland, 4141 Fi h Avenue, Pi sburgh, Pennsylvania. Â


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