STARFLEET Annual Awards – Submission Form

Annual Award Nomination Form

Each Region may submit ONE nominee per category, per year. Nominations should be submitted by the Regional Coordinator, or an authorized representative. Nominations for this years Annual Awards will be accepted from April 1 through May 15.

Submitter Information
Submitter Name
First Last
Email*
Region*
Regional Position:*
- Regional Coordinator
- Vice Regional Coordinator
- Awards Director
Nominee Information
Nominee Name*
First Last
Rank*
Chapter*
SCC #
Expiration Date*
MM slash DD slash YYYY
Name of Award*
Basis for Recommendation*
Please tell us why you are nominating this STARFLEET member.
750 Word limit
Phone
This field is for validation purposes and should be left unchanged.

STARFLEET Annual Awards – Submission Form

Annual Award Nomination Form

Submitter Information

Nominee Information