CARLISLE BARRACKS VOLUNTEER AWARD NOMINATION FORM

PLEASE INDICATE THE TYPE OF AWARD FOR WHICH INDIVIDUAL / AGENCY IS BEING NOMINATED

____Certificate of Appreciation ____Letters of Commendation ____Volunteer Youth of the Quarter Award (per agency) ____Star Letters ____Volunteer Youth of the Year (per agency) ____Citizenship Award for Humanitarian ____MWR Certification of Appreciation Service ____Volunteer of the Quarter Award (per agency) ____Commander's Award for Public Service ____Commander's Award for Public Service ____Volunteer of the Year Award (per agency) ____Civilian Award for Humanitarian Service ____Certificate of Appreciation for Patriotic Civilian Service

PART I #______(For office use only) NAME OF NOMINEE ______RANK (if military) ______VOLUNTEER AGENCY______ADDRESS______

WORK PHONE NUMBER ______TOTAL HOURS OF VOLUNTEER SERVICE______NAME OF NOMINATOR ______SIGNATURE OF NOMINATOR______

PART II #______(For office use only)

1. LIST SPECIFIC CONTRIBUTION(S) MADE BY VOLUNTEER/AGENCY DURING PERIOD LISTED: (ADDITIONAL SPACE PROVIDED ON REVERSE SIDE)

FROM: ______TO: ______

2. HOW DID THIS VOLUNTEER/AGENCY IMPROVE THE QUALITY OF LIFE AT CARLISLE BARRACKS? ______15 FEB 08 CARLISLE BARRACKS VOLUNTEER AWARD NOMINATION FORM

PART III #______(For office use only)

1. IN THE SPACE BELOW, PROVIDE PROPOSED CITATION (NOT TO EXCEED 9 LINES), DESCRIBING THE INDIVIDUALS OR AGENCY'S CONTIBUTION(S). INCLUDE FULL NAME, DATES OF WORK, NAME OF ORGANIZATION AND SPECIFIC ACCOMPLISHMENTS. ______

(ADDITIONAL SPACE FOR PART II) ______

2. RETURN NOMINATION FORM TO THE INSTALLATION VOLUNTEER COORDINATOR, ARMY COMMUNITY SERVICE, BLDG 46, ASHBURN DR, CARLISLE BARRACKS, PA 17013

PRIVACY ACT STATEMENT: PRESCRIBING DIRECTIVE: AR 608-1. AUTHORITY: TITLE 10, USC, SECTION 3012. PRINCIPAL PURPOSE: TO RECORD ESSSENTIAL BACKGROUND INFORMATION

ON VOLUNTEERS. ROUTINE USES: COORDINATING VOLUNTEER SERVICES AT CARLISLE BARRACKS, PA, RECRUITING VOLUNTEERS AND PLANNING VOLUNTEER AWARD PROGRAMS.

MANDATORY OR VOLUNTEER DISCLOSURE AND EFFECTS ON INDIVIDUAL NOT PROVIDING INFORMATION IS VOLUNTARY. NOT PROVIDING INFORMATION WILL PREVENT KEEPING A

RECORD OF INDIVIDUAL VOLUNTEER QAULIFICATIONS AND SERVICES AND MAY PREVENT VOLUNTEERS FROM RECEIVING AWARDS.

15 Feb 08