OSFM Lifetime Achievement Nomination Form

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OSFM Lifetime Achievement Award Nomination Form

Nominee's Full Name

Please provide the nominee's full name as it should appear on the award.

Fire Department/Agency Name

Nominee's Rank/Position

Nominee's Cell Phone

Nominee's Email Address

Nominator's Full Name

Relationship to Nominee

Nominator's Cell Phone

Nominator's Email Address

Contributions to the Fire Service

Outline the nominee's significant contributions and achievements throughout their career in the fire service.

Leadership and Mentorship

Describe how the nominee has demonstrated leadership qualities and served as a mentor or role model to others within the fire department.

Community Impact

Provide examples of how the nominee has positively impacted the community through their involvement in firefighting and related activities.

Proposed Date and Time of Award Ceremony

Proposed Location of Award Ceremony

This nomination is a surprise. Please do not contact the nominee directly.