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Law Enforcement Medal of Valor Nomination Form

Please Complete this form for the Medal of Valor


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brown bulletpointMedal of Valor


The Law Enforcement Medal of Valor award is based upon the following criteria.  We encourage you to provide several examples of the nominee’s outstanding service in any or all of the listed criteria.

The Law Enforcement Medal of Valor award - Heroism involving the voluntary risk of an employee’s own safety in the attempt to save the life of another.  Or bravery above and beyond the call of duty in the apprehension of an armed and dangerous adversary who, if allowed to remain at large, would present an imminent and substantial danger to the community, and where such apprehension constitutes a real and present danger to the employee’s life.



Medal of Valor Nomination Form

Fill out the form below. All fields with (*) are required.

* Date of Nomination :
* Nominee (if known) :
* Nominator:
* Nominator email:
* Nominator Phone:
* Give detailed description of event and how your nominee performed
        to deserve this award.
Attach additional pages if necessary:


Please print and mail this form to the Sheriff's Office.




If additional room is needed, please attach additional page(s) to this form.

Return this completed form as indicated on Instruction Page.  Nominations will be considered and reviewed within 60 days of submission.


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