Employer Support of the Guard and Reserve > Employer Awards > Patriot Award

Supervisor information:

* Supervisor Name * This is a required field.

* Address * This is a required field.

* State/APO/FPO: * State is a required field.

Phone * This is a required field.

* Business/Company where you work: * This is a required field.

City

* ZIP * Zip is a required field.

Website

Nominator's (service member) information:

* First Name * This is a required field.

* Last Name * This is a required field.

Middle Initial

* Rank: * This is a required field.

Address

* State/APO/FPO * State is a required field.

* Email * This is a required field. * Invalid email address

City

* ZIP * Zip is a required field.

* Phone * This is a required field.

* Component: * This is a required field.

Your National Guard or Reserve unit information:

* Your Unit: * This is a required field.

Unit Address:

* State/APO/FPO: * State is a required field.

Commander's Full name: * This is a required field.

Unit Identification Code:

City

* ZIP * Zip is a required field.

Rank

Your boss may be eligible for higher recognition, but only if you take the time to explain. Please write a few sentences below to explain why your boss deserves this recognition:

My supervisor(check all that apply):

	is highly supportive of my National Guard or Reserve service -- even when I am called on short notice.
	outwardly recognizes me as a special asset because I am in the National Guard or Reserve.
	continues my salary when I am on active duty.
	continues company benefits while I am on active duty.
	hires someone to fill in for me when I am on annual training duty without penalizing me.
	keeps in touch with my family when I am on active duty for more than 30 days.
	should be considered for a higher level award.

Certificate Mailing Instruction:

	Please send the award to the ESGR State Committee in the state where my employer/supervisor is located, for formal presentation to my employer/supervisor.
	Please send to my home address.

Presentation Options:

	Please send the award framed.
	Please send the award in a certificate holder.

Privacy Act Statement

"Authority: 38 U.S.C. Chapter 43, Employment and Reemployment Rights of Members of the Uniformed Services (USERRA); DoD Directive 1250.1, National Committee for Employer Support of the Guard and Reserve; DoD Instruction 1205.22, Employer Support of the Guard and Reserve; and DoD Instruction 1205.12, NCESGR Instruction 1250.28, Employer Awards.

Purpose: To allow members of the National Guard and Military Reserve Component personnel and their family members to submit nominations for Employer Awards.

Routine Use(s): To process awards for Civilian Employer nominated by National Guard and US Military Reserve personnel and to collect and report statistical data for annual reports to Congress and appropriate DoD agencies about Employer Support of the Guard and Reserve Activities.

Disclosure: Voluntary; however, failure to provide accurate contact information and other solicited information may prevent or delay processing the request."

* Initials * This is a required field.

Date

Submit

Guard and Reserve - Nominate Your Supportive Supervisor for the Patriot Award

Supervisor information:

Nominator's (service member) information:

Your National Guard or Reserve unit information:

Your boss may be eligible for higher recognition, but only if you take the time to explain. Please write a few sentences below to explain why your boss deserves this recognition:

Privacy Act Statement

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