Nomination for the Queen's Diamond Jubilee Medal –
For Members of the Air Force Association of Canada

Some information may require you to consult the on-line membership database, accessible here (http://airforce.ca). Your e-mail address must first be recorded in the database before you can access information. Consult with the Executive Director at (toll-free) 1-866-351-2322 ext. 222 or should you have any questions.

Required fields are marked with an asterisk (*).

Nominator's Contact Information (Treated as Confidential)

First and Last name of individual making nomination * Email Address * Telephone Number * Nominator's Membership Number (If Applicable) * Nominator's Wing Number *
(or enter "MAL" for Members-at-Large)

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Name of Nominee as it will appear on the certificate

Honorary Title Military Rank * Select Military Rank Private [Pvt] Corporal [Cpl] Leading Aircraftman [LAC] Master Corporal [MCpl] Flight Sergeant [FSgt] Sergeant [Sgt] Flying Officer [FO] Flight Lieutenant [FLt] Pilot Officer [PO] Warrant Officer [WO] Master Warrant Officer [MWO] Chief Warrant Officer [CWO] Officer Cadet [OCdt] 2nd Lieutenant [2Lt] Lieutenant [Lt] Captain [Capt] Major [Maj] Squadron Leader [SLdr] Lieutenant Colonel [LCol] Wing Commander [WComd] Colonel [Col] Group Captain [GCapt] Brigadier-General [BGen] Major-General [MGen] Lieutenant-General [LGen] General [Gen] Not Applicable Other (specify below) Full Name * Post-nominals Nominee's Membership Number (Consult the Membership Database Portal to retrieve this information) Wing Number or enter 'MAL' for Members-at-Large

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Address of Nominee

(Consult the Membership Database Portal to retrieve this information)

Address * City / Town * Province or State * Postal Code Country

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Language * Select Language English French Other Gender * Select Gender Male Female Age Group * Select Age Group Child Youth Teenager Adult Senior Nominee's Field of Enveavour:

Aerospace Veteran Canadian Forces
Education History & Heritage Philanthropy
Public Service Community Service Voluntary Service
Other (please specify below)

 
Current position of the Nominee

Regular Member Associate Member Honorary Member
Wing Executive Member Group Executive Member National Executive Member
Staff Member Other (please specify below)

 
Summary *
Brief description of the Nominee's achievements you feel merit the awarding of the Queen's Diamond Jubilee Medal.
Max: 850 characters —   Remaining

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