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Service Members - Nominate Your Supportive Supervisor for the Patriot Award

Recognize your supervisor for supporting National Guard and Reserve members by nominating him or her for a Patriot Award! Your supervisor will receive a beautiful Department of Defense Certificate of Appreciation (framed if desired) and lapel pin. All members of the National Guard and Reserve are eligible to nominate, and you may nominate as many worthy supervisors as you would like! Simply complete and submit a nomination for each!

Please note:

- Patriot Awards are awarded to individual supervisors, not an entire staff or the employing organization as a whole. Certificates are printed with your supervisor's name, so please enter information exactly as you would like it printed; only one name per nomination. Also - be sure to select whether you'd prefer the certificate shipped in a certificate holder or framed for hanging.

- You may request a Patriot Award be sent to either your home address or to the ESGR State Committee in your supervisor’s state.

- The average turnaround time for the Patriot Award to reach the address provided is 45 days from the date of submission. If you have not been contacted or received the Patriot Award 45 days after submitting your nomination, you may use the “State Pages” link at the top of the ESGR webpage to get an update from the appropriate State Committee.

- Items preceded with an asterisk (*) are required. All fields are case sensitive.

Supervisor information:

* Supervisor's First and Last Name
This is a required field.

* Address
This is a required field.

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

Supervisor Email

Website

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

* City
This is a required field.

* ZIP
This is a required field.

* Phone
This is a required field.

Nominator's (service member) information:

* First Name
This is a required field.

* Last Name
This is a required field.

* Address
(Include Apt number – PO Box numbers are not allowed)
This is a required field.

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

* Email
This is a required field. Invalid email address

Middle Initial

* Rank:
This is a required field.

* City
This is a required field.

* ZIP
This 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:
This is a required field.

Commander's name:

Unit Identification Code:

City

* ZIP
This is a required field.

Commander's Rank

Your supervisor 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 supervisor 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:

This is a required field.

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 Reserve Component personnel and their family members to submit nominations for Employer Awards.

Routine Use(s): To process awards for Civilian Employers nominated by National Guard and 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

Please note that the average turnaround time for the Patriot Award to be delivered is 45 days from the date of submission.