Skip to Main Content
Loading
Loading
Explore Elgin
Residents
Government
Doing Business
I Want To...
You Are Here:
Home
Form Center
A
A
Form Center
Search Forms:
Search Forms
Select a Category
All Categories
Art Showcase
Centre
Communications
Express Your Views about Elgin
Fire Department
General Forms
Graffiti
Hemmens Cultural Center
Landlord Training Program
Parks and Recreation
Police Department
Purchasing Forms
Security Through Surveillance
Special Events and Cultural Arts
Sustainability Commission
Website Beta
Website Feedback
Zoom_PD
By
signing in or creating an account
, some fields will auto-populate with your information and your submitted forms will be saved and accessible to you.
Award Nomination Form
Sign in to Save Progress
This form has been modified since it was saved. Please review all fields before submitting.
Date Submitted
*
Date Submitted
Name of person submitting nomination
*
Submission for:
*
Fire Service
Police
Civilian
Other (i.e. other city department, etc.)
Employee or EPD Officer name, rank and badge number if pertinent to the award
Shift on Duty
1st
2nd
3rd
Stations that responded
Station 1
Station 2
Station 3
Station 4
Station 5
Station 6
Station 7
Date of incident
*
Date of incident
Alarm number if applicable
Please list the names of all nominees
*
If a crew award please ensure all personnel that responded on the call are listed.
Please provide all pertinent contact information for civilian award nominees
Please provide a very detailed description of the incident and the actions taken to warrant the recognition
*
Please submit additional documentation (i.e. newspaper articles, letters, witness statements, etc.) to Awardscommittee@cityofelgin.org
Please cc' this form to the Staff Officers assigned to the shift on which the incident occurred.
Leave This Blank:
Receive an email copy of this form.
Email address
This field is not part of the form submission.
Submit
* indicates a required field
About Elgin
Agendas & Minutes
City Code
Contact the Mayor & City Council
Freedom of Information Act (FOIA)
Frequently Asked Questions (FAQs)
Newsroom
Public Hearings
Transparency
Video Center
Arrow Left
Arrow Right
[]
Slideshow Left Arrow
Slideshow Right Arrow