OPOA AWARD NOMINATION FORM

Nominations are now being accepted for the 2008 Awards Banquet, and are due by August 1, 2008.  For additional information, please call the OPOA office at 503-393-9237.

Name/Rank:                                                                                                   Date:

Department/Employer:                                                                                   Phone:

Your Involvement in Incident/Relationship to Nominee:

Award Recommendation (Refer to Award Criteria /Award Committee will make final determination):

Nominee Information (please submit one form per nominee/incident)

Nominee/Rank:                                                                                              Svc. Years:

Department/Employer:                                                                                   Phone:

Address:

Chief/Sheriff:

Date of Incident:                                              Type of Incident:

Actions Performed by Nominee:

Attach additional pages / reports as needed

Print and mail this form to:  OPOA Awards Program  P.O. Box 9211  Brooks, OR 97305