AUSA National Award Nomination Form

Please begin by selecting the award you would like to nominate an individual for who, in various capacities, has served the Army and the Association with distinction.
AWARD NAME*
Deadlines:
- Deadline for all submissions is July 1.
Deadlines:
- 1 June - Chapters submits nominations by selecting respective region below for review by Region President.
- 1 July - Region Presidents must approved one nomination to be reviewed by AUSA National Awards Committee.
Review Deadlines:
- Chapters must submit their nomination for their Region President's review.
- Regions must review chapter nominations and approve one nomination as their Region Volunteer Family of the Year, (who will be recognized at the AUSA Annual Meeting) for consideration from AUSA National Awards Committee (NLT 1 July).
Deadlines:
- 1 June - Chapters submits nominations by selecting respective region below for review by Region President.
- 1 July - Region Presidents must approved one nomination to be reviewed by AUSA National Awards Committee.
Review Deadlines:
- Chapters must submit their nomination for their Region President's review.
- Regions must review chapter nominations and approve one nomination as their Region Army Civilian of the Year, for consideration from AUSA National Awards Committee (NLT 1 July).
NOMINATOR CONTACT INFORMATION
NOMINATOR NAME*

First NameLast Name
NOMINATOR CHAPTER*
NOMINATOR REGION*
Note: This submission will be sent to your region president for approval.
NOMINATOR ADDRESS*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
NOMINATOR PHONE NUMBER*

Area CodePhone Number
NOMINATOR EMAIL ADDRESS*
NOMINEE CONTACT INFORMATION
MILITARY RANK*
NOMINEE NAME*

First NameLast Name
NOMINEE ADDRESS*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
NOMINEE PHONE NUMBER*

Area CodePhone Number
NOMINEE EMAIL ADDRESS*
FAMILY INFORMATION
SPOUSE NAME
NAMES AND AGE OF CHILDREN/DEPENDENTS*
Are they AUSA members?*

YesNo
HOME ADDRESS*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
CELL PHONE NUMBER*

Area CodePhone Number
ALTERNATE CONTACT NUMBER

Area CodePhone Number
EMAIL(S)*
STATUS*

Regular ArmyArmy National GuardU.S. Army ReserveDA CivilianSurviving Family
INSTALLATION/COMMUNITY INFORMATION *
Name of Installation/or City and State represented
ACTIVITIES, AWARDS, WRITE-UP
Please provide a List of Volunteer Activities - ( April 2022 - April 2025 ) :*

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Please provide a List of Awards ( April 2022 - April 2025 ) :*

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Please provide a narrative (No more than 800 words)*
( Word Documents or PDFs are accepted )
I verify that the family nominated above has performed the volunteer service as described.
Please select a signature option*

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Please provide your signature:*

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Upload an image of your signature:*

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I verified that the family nominated above has performed the volunteer service as described.*

Verified
Please provide a short bio of the nominee:*

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Please provide supporting rational for the nomination:*

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Please provide an endorsement letter:

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Please provide an endorsement letter for the nominee from their local commander:*

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If you have any questions, please contact LaSherryn Duncan, lduncan@ausa.org.
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NOMINATOR CONTACT INFORMATION

NOMINEE CONTACT INFORMATION

FAMILY INFORMATION

ACTIVITIES, AWARDS, WRITE-UP

DOCUMENT UPLOAD