ACC63.1 Air Cadet League of Canada Member Long Service Medal - Approval Form

ACC63.1- ACL VOLUNTEER LONG SERVICE MEDAL FORM TO BE APPROVED/RECOMMENDED

This form must be completed by the Provincial/Territorial Chair (or designated person) or the National Honours & Awards Committee Chair (if the nominee is a national volunteer)

Step 1 of 2

ACC63.1 ACL VOLUNTEER LONG SERVICE MEDAL APPROVAL/RECOMMENDATION FORM

Identify the Nominee

First Name(Required)

Last Name(Required)

Nominee belonging to QOVPC

If the nominee is living in ON and is volunteering for the Quebec & Ottawa Valley Provincial Committee, please check this box.First Choice

RECOMMENDATION / APPROVAL(Required)

P/TC Chairperson, PC of the HAC, or Chair of the National HAC.

The Medal and / or bars are to be presented at(Required)

The National Annual General Meeting in June

Other

If other, please provide specifics.

Medal and / or bars are to be sent to:(Required)

Name

Address(Required)

Street Address Address Line 2 City Province Postal Code

Chair's First name(Required)

Name of the Chair (or designate) who will approved the nomination

Chair's Last name(Required)

Phone(Required)

Email(Required)

Date(Required)

Signature(Required)

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Applications for the Air Cadet League of Canada Volunteer Long Service Medal can be made at any time. Approving authority will be responsible for the costs associated with the medals and bars.