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REQUEST FOR THE MEDAL OF THE

ARCHDIOCESE FOR THE MILITARY SERVICES
TO: The Awards Committee
Archdiocese for the Military Services
PO Box 4469
Washington, DC 20017-0469
“THE MEDAL OF THE ARCHDIOCESE FOR THE MILITARY SERVICES WILL NORMALLY BE LIMITED TO FIVE NOMINEES EACH YEAR.”
“TWO SETS OF DETERMINANTS ARE CONSIDERED:
1.  CONTRIBUTIONS TO THE CATHOLIC RELIGIOUS PROGRAM,AND
2.  THE CHARACTER OF THE NOMINEE.”
I.  The Medal is requested by:
Name:
Position:
Mailing address:
Telephone: (Commercial)
II.  The Medal is to be presented to:
Name:
Position:
Mailing address:
Telephone: (Commercial)
III.  The Nominee contributed to the Catholic Religious program
of: (Installation)
For: (Period of time)
without pecuniary remuneration of any kind.
A.  Check where appropriate:
1.  Choir
2.  Usher
3.  Extraordinary Minister of Holy Communion
4.  CCD
5.  Deacon
6.  Music Ministry
7.  Cursillo activities
8.  Catholic men/women organization
9.  Lector/commentator
10.  Liturgy Committee
11.  Parish Council
12.  Other (designate)
B.  Please explain in narrative form why you think the Nominee excelled in the voluntary services he rendered to the people of the Archdiocese for the Military Services:
C.  Character of Nominee:
1.  Marital Status:
2.  Age:
3.  Number of Children:
4.  If Married:
a) Church of marriage and name of priest-witness of the
marriage:
b)  Date of marriage:
5.  How often does the nominee participate in the Mass,
Receive Communion, etc.?
6.  What is the religion of the Nominee’s wife/husband and
children?
7.  What is the Nominee’s reputation and standing in the
community?
8.  Is the Nominee faithful to the official teaching of the
Church?
9.  To your knowledge, has the Nominee ever been involved in
controversy concerning the teaching of the Church?
10.  Please state the Nominee’s qualifications,
character-wise, in brief narrative form:
IV.  If the Nominee is active military, please complete the following:
1.  Rank/Grade
2.  Military organization
3.  Branch of service
4.  Length of time in service
V.  If the request for the Medal of the Archdiocese for the Military Services is approved, it should be mailed to:
Signature:
Name:
Mailing address:
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(Only For Use of the Board of Review)
Approved:
Disapproved:
Reason for disapproval:
Date
Signature