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Staff Manual Guide 3113.10, Attachment A

Format For Making Recommendations For PHS Commissioned Corps Awards

The information in parentheses describes the data to be entered. Use plain bond paper and single space the justification statement. Try not to exceed three pages.

(Actual size 8" x 10 1/2")

NOMINATION FOR
(Distinguished Service Medal)
(Meritorious Service Medal)
(Commendation Medal)
(PHS Plaque)
Name of Officer: (Robert F. French, Jr.)
Organization: (HEW/PHS/FDA/Bureau of Radiological Health Division of Compliance)
Organization Position Title: (Radiation Control Officer)
Present Grade: (Senior Sanitarian (T) (05) )
Other Honors Received:  
Proposed Citation: (Twenty-five (25) words or less describing the accomplishments. Begin the citation with -- In recognition of... --or-- For...)
Justification Statement: (Concisely, clearly, and completely describe the officer's accomplishments and explain how these accomplishments meet the criteria set forth for the award. Do not include the biographical sketches, education, training and experience unless it is necessary for an understanding of the officer's accomplishments)