USPCA Region 12 Award Nomination Form
Officer Name and K9 Name
Please put the names here how you want them to appear on your award. For example, "SGT George Vinson and K9 Earl"
Enter as you want it to appear on award,
Example - "Fargo Police Department" or "Fargo PD"
Type case number as you want it to appear on award
Date of Deployment
Enter Date of deployment
Detector (includes EOD)
Patrol (includes tracking)
Enter nomination here, be sure to include actions from K9 team which make them worthy for award. This can be a summary of a case report.
Enter your emial address to receive results of submission