Patriot Award - Spouse Nominator (Nominate Employers Only)

Spouses award your employer! Recognize your boss for his or her support of you as the spouse of a Guardsmen or Reservist. Nominate him or her for a "Patriot Award". Your employer will receive a Department of Defense Certificate of Appreciation and a Patriot lapel pin. All spouses of Guardsmen and Reservists are eligible to nominate their employers.

Please note: Certificates are printed with your employer's name, so please enter only one name per nomination. The standard turnaround time for the Patriot Award to reach the address provided is 30-45 days from the date of submission.
Items preceded with an asterisk (*) are required. All fields are case sensitive. Also note that either a valid phone number or email address is required.

Nominator's 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 information:

* First Name * This is a required field.

* Last Name * 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.

Your Military Spouse's National Guard or Reserve unit information:

* Component: * This is a required field.

* Their Unit: * This is a required field.

Unit Address:

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

Spouse first name:

Military Spouse Rank:

Unit Identification Code:

City

* ZIP * Zip is a required field.

Spouse last name:

Please write a few sentences below to explain why your supervisor deserves this recognition:

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: 5 U.S.C. 552a, the Privacy Act of 1974; 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; DoD Instruction 1205.12, Civilian Employment and Reemployment Rights of Applicants for, and Service Members and Former Service Members of the Uniformed Services, NCESGR Instruction 1250.30 Secretary of Defense Employer Support Freedom Award, 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; and to allow civilian Employers to request a Statement of Support.

Routine Use(s): To process awards for Civilian Employer support of National Guard and US Military Reserve personnel; and To coordinate signing of Statements of Support with employers of National Guard and Reserve Component 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

For more information, call 1-888-651-0389 or click to send an email.

Please note that the standard turnaround time for the Patriot Award to reach the address provided is 30-45 days from the date of submission.

Patriot Award - Spouse Nominator (Nominate Employers Only)

Nominator's supervisor information:

Nominator's information:

Your Military Spouse's National Guard or Reserve unit information:

Please write a few sentences below to explain why your supervisor deserves this recognition:

Privacy Act Statement

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