MPA Awards NominationStep 1 of 520%MPA Awards Nomination FormPlease provide your informationName of Person Submitting the Nomination(Required) First Last Your Email Address(Required) Enter Email Confirm Email Phone Number(Required)Agency InformationChief of Police Name(Required) First Last Agency(Required)Chief of Police Email:(Required)Chief of Police Phone Number:(Required)Agency Address(Required) Street Address Address Line 2 City State AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific ZIP Code Supporting Report & DocumentationPlease attach any police incident report or report that summarizes the incident that is being recognized. Please be advised that all incidents must be approved by the Chief of the Agency for nomination and if it was an Officer Involved Shooting, the report should be cleared by the appropriate District Attorney’s Office prior to submitting nominations.Upload Report(s) or Supporting DocumentsAttach Report or Supporting Documents Drop files here or Select filesAccepted file types: doc, docx, pdf, txt, Max. file size: 25 MB.Nominee InformationPlease provide the name of the person that is being nominated. If additional personnel are being nominated please use the box below to identify those officers and their associated department as well as the award they are being nominated for.Name of Nominee(Required) First Last Rank(Required)Award Type(Required) Medal of Honor Medal of Valor Meritorious Service Medal Life Saving Medal Distinguished Service Medal Chief Paul Doherty AwardAdditional Nominees and Award Requested (if Applicable) can be entered belowDisclaimer(Required)Disclaimer: Submission of an awards nomination is contingent upon the incident in question having been fully reviewed and cleared by the appropriate department personnel and, if applicable (e.g., in the case of an Officer Involved Shooting), the District Attorney’s Office. Additionally, the Chief of the Nominee’s agency must be informed and aware of the nomination prior to its submission. I acknowledge the disclaimerUntitled Choice number 1 does not have an image First Choice Choice number 2 does not have an image Second Choice Choice number 3 does not have an image Third Choice
