Ordnance Order of Samuel Sharpe Nomination (revised 6/2012)

Please mail or fax the below form to: / Submission Instructions:
U.S. Army Ordnance Corps Association
P.O. Box 5251
Fort Lee, Virginia 23801
Telephone # 804-733-5596
Fax# 804-733-5599 / Complete and print below nomination form
Submit through chain of command for required signatures
Mail nomination form with correct payment
Confirm receipt of nomination form 7 days after submission
All awards are mailed to the nominator unless otherwise specified!!
AWARDEE
Name / Address
Rank / Title / City
SSN / State
Unit / Organization / Zip Code / APO / APO
NOMINATOR
Name / Address
Rank / Title / City
SSN / State
Unit / Organization / Zip Code / APO / APO
Email address / ______/ ______
Work Phone / Signature
ENDORSER
Name / Rank / Title
Email address / ______/ ______
Unit / Organization / Signature
APPROVAL AUTHORITY
Name / Rank / Title
Unit / Organization / Signature
NOMINATED INDIVIDUALS SIGNIFICANT CONTRIBUTION TO THE U.S. ARMY ORDNANCE CORPS ON A SEPARATE PAPER
(MAXIMUM OF SIX BULLETS)

Please check one of the following.

I have enclosed a Check / Money Order for the amount of :
Make Check / Money Orders payable to: USAOCA
Pleases charge my for: ( we must have credit card code for processing. )
Credit Card number Expiration Date: / code number______(3#code located on the back of credit card)
Name on the Credit Card
SIGNATURE: DATE:
NOTE: Your signature is required for Credit Card purchases.