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Northern Division Patriot Star Award

Northern Division Patriot Star Award
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Full Name
Phone Number
Email Address
NSP Member Number
Year Joined the NSP
Patroller Status
Current Patroller Type
Name of Nominee's Current Patrol
Military Department, Component and Branch or Class
Service Entry Date
Service Discharge Date
Type of Transfer or Discharge
Total Time on Active Duty - Years
Total Time on Active Duty - Months
Total Time on Active Duty - Days
Foreign and/or Sea Service - Years
Foreign and/or Sea Service - Months
Foreign and/or Sea Service - Days
Combat/War Zone (if Berlin before 11/1990)
Yes
No
Character of Service from DD Form 214
Name, Email, Phone #
NSP Member Number, Year Joined, and Status
Current Patroller Class
Name of Current Patrol
Have you informed the nominee and received concurrence for this nomination?
Yes
No
Signature of Sponsor
Draw your signature in the area above, or use the saved signature button if available.
Date
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