Award Nomination

Award Nominee Information

Nominee's Award Type(Required)

Nomination Category(Required)

Career

Volunteer

Nominee's County (Primary Agency)(Required)

Nominee's Primary Agency Affiliation (AL)(Required)

Nominee's Primary Agency Affiliation (AA)(Required)

Nominee's Primary Agency Affiliation (BA)(Required)

Nominee's Primary Agency Affiliation (BC)(Required)

Nominee's Primary Agency Affiliation (CA)(Required)

Nominee's Primary Agency Affiliation (CR)(Required)

Nominee's Primary Agency Affiliation (CL)(Required)

Nominee's Primary Agency Affiliation (CE)(Required)

Nominee's Primary Agency Affiliation (CH)(Required)

Nominee's Primary Agency Affiliation (DC)(Required)

Nominee's Primary Agency Affiliation (DO)(Required)

Select Your Primary Agency Affiliation (US)(Required)

Nominee's Primary Agency Affiliation (FR)(Required)

Nominee's Primary Agency Affiliation (GA)(Required)

Nominee's Primary Agency Affiliation (HA)(Required)

Nominee's Primary Agency Affiliation (HO)(Required)

Nominee's Primary Agency Affiliation (KE)(Required)

Nominee's Primary Agency Affiliation (MO)(Required)

Nominee's Primary Agency Affiliation (PG)(Required)

Nominee's Primary Agency Affiliation (QA)(Required)

Nominee's Primary Agency Affiliation (SO)(Required)

Nominee's Primary Agency Affiliation (SM)(Required)

Nominee's Primary Agency Affiliation (MD)(Required)

Nominee's Primary Agency Affiliation (VA)(Required)

Nominee's Primary Agency Affiliation (TA)(Required)

Nominee's Primary Agency Affiliation (WA)(Required)

Nominee's Primary Agency Affiliation (WI)(Required)

Nominee's Primary Agency Affiliation (WO)(Required)

Nominee's Name(Required)

Nominee's Current Position(Required)

Nominee's Address(Required)

Nominee's Primary Phone(Required)

Nominee's Email Address(Required)

Nominator Information

Nominator's County (Primary Affiliation)(Required)

Fill out the following information for the agency where you previously were a chief officer:

Select Agency Affiliation (AL)(Required)

Select Agency Affiliation (AA)(Required)

Select Agency Affiliation (BA)(Required)

Select Agency Affiliation (BC)(Required)

Select Agency Affiliation (CA)(Required)

Select Agency Affiliation (CR)(Required)

Select Agency Affiliation (CL)(Required)

Select Agency Affiliation (CE)(Required)

Select Agency Affiliation (CH)(Required)

Select Agency Affiliation (DC)(Required)

Select Agency Affiliation (DO)(Required)

Select Agency Affiliation (US)(Required)

Select Agency Affiliation (FR)(Required)

Select Agency Affiliation (GA)(Required)

Select Agency Affiliation (HA)(Required)

Select Agency Affiliation (HO)(Required)

Select Agency Affiliation (KE)(Required)

Select Agency Affiliation (MO)(Required)

Select Agency Affiliation (PG)(Required)

Select Agency Affiliation (QA)(Required)

Select Agency Affiliation (SO)(Required)

Select Agency Affiliation (SM)(Required)

Select Agency Affiliation (MD)(Required)

Select Agency Affiliation (VA)(Required)

Select Agency Affiliation (TA)(Required)

Select Agency Affiliation (WA)(Required)

Select Agency Affiliation (WI)(Required)

Select Agency Affiliation (WO)(Required)

Nominators Name(Required)

Nominator's Current Position(Required)

Nominator's Address(Required)

Nominator's Phone Number(Required)

Nominator's Email Address(Required)

Chief Leonard T. King, Sr. Medal of Valor Award Nomination Information

To recognize a Maryland fire, rescue and/or EMS provider(s) of an organized Maryland fire, rescue or EMS department who have, at great personal risk, been credited with saving or attempting to save a human life in an extreme emergency situation in the past year since the previous award.

Date of Heroic Act(Required)

Nominee's Actions(Required)

Please describe the act or acts of heroism for which the nominee displayed personal bravery or self-sacrifice so extraordinary as to set the individual apart from his or her fellow emergency service providers whereas they risked their personal safety of life.

Signature(Required)

Signature of individual submitting the Chief Leonard T. King, Sr. Medal of Valor Award nomination application.

Chief Leslie B. Thompson Memorial Award Nomination Information

To recognize an individual of the Maryland fire, rescue or emergency services community who has made an outstanding contribution to the future welfare of the fire, rescue and emergency medical services of Maryland.

Nominee's Actions(Required)

Please describe the outstanding contributions that the nominee has made to the welfare of the fire, rescue and emergency medical services of Maryland. In addition please describe distinguished services that the nominee has provided to their department, other departments; and to their county, other counties, regional organizations and the State of Maryland.

Signature(Required)

Signature of individual submitting the Chief Leslie B. Thompson Memorial Award nomination application.

Chief John W. Hoglund Leadership Award Nomination Information

To recognize a member of the Maryland fire, rescue or emergency services community who has displayed leadership in advancing the health, safety and readiness of the Maryland fire, rescue and emergency services.

Nominee's Actions(Required)

Please describe how the nominee has emphasized leadership, innovation, professional development, safety and health, integrity, service to the public and contributions to the fire and emergency services at the local, state and national levels.

Signature(Required)

Signature of individual submitting the Chief John W. Hoglund Leadership Award nomination application.

Chief Charles N. Black IV Hall of Fame Award

To recognize an individual who has provided distinguished service to the MFCA and an individual department or county fire or rescue service.

Nominee's Actions(Required)

Please describe how the nominee has provided distinguished service to the MFCA and an individual department or county fire or rescue service. Nominees must have a minimum of ten (10) years of service to be eligible for consideration. Nomination to the Hall of Fame should be based upon distinguished service to the MFCA. Distinguished service to the nominees’ individual department/company or county may be considered.

Signature(Required)

Signature of individual submitting the Chief Charles N. Black IV Hall of Fame award nomination application.

Maryland

Fire Chiefs Association

Award Nominee Information

Nominator Information

Chief Leonard T. King, Sr. Medal of Valor Award Nomination Information

Chief Leslie B. Thompson Memorial Award Nomination Information

Chief John W. Hoglund Leadership Award Nomination Information

Chief Charles N. Black IV Hall of Fame Award

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Maryland

Fire Chiefs Association

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© All rights reserved
Fire/EMS Department Websites, Hosting & Support Powered By

Maryland

Fire Chiefs Association

Award Nomination

Award Nominee Information

Nominator Information

Chief Leonard T. King, Sr. Medal of Valor Award Nomination Information

Chief Leslie B. Thompson Memorial Award Nomination Information

Chief John W. Hoglund Leadership Award Nomination Information

Chief Charles N. Black IV Hall of Fame Award

Our Sponsors

Click Here to Inquire About Becoming a Maryland Fire Chiefs Association Sponsor

Maryland

Fire Chiefs Association

Stay Informed

Partners

© All rights reservedFire/EMS Department Websites, Hosting & Support Powered By

© All rights reserved
Fire/EMS Department Websites, Hosting & Support Powered By