SCRA Award Application

AWARD MUST BE PURCHASED BEFORE APPLICATION IS SUBMITTED     All information received will be strictly confidential. Application will not be processed without a valid PayPal ID transaction number. Pay Pal ID Transaction Number                                            Recommended Award (Ordering more than one type of award, new order is required). Silver Order of Mercury Bronze Order of Mercury Silver Wahatchee Bronze Wahatchee Brevet Colonel Quantity 1 2 3 4 5 Today's Date                                           Date 1st Award Required (If within 30 days of today's date, PURCHASE LATE FEE AWARD (s)         Late Award Purchase Required NO YES    1. Identify the Commander (COL or above) approving the award. Recommender/Approval Authority Signature Block & E-mail                              Name (POC), Mailing Address, Telephone, and Email for shipping award. 2. Identify the Awardee (s) and date of award to be inscribed on the certificate (s):  (Order will not be processed unless the awards ordered are paired with Awardee Recipients).  1.    Date of Award To Be Inscribed  1a. Rank        1b. Last Name                           1c. First Name                         1d. Middle Initial                          1e. Meets award criteria YES NO   (Must be a member of SCRA). 1f. SCRA Member YES NO 2.    Date of Award To Be Inscribed  2a. Rank        2b. Last Name                           2c. First Name                         2d. Middle Initial                          2e. Meets award criteria YES NO   (Must be a member of SCRA). 2f. SCRA Member YES NO 3.    Date of Award To Be Inscribed  3a. Rank        3b. Last Name                           3c. First Name                         3d. Middle Initial                          3e. Meets award criteria YES NO   (Must be a member of SCRA). 3f. SCRA Member YES NO 4.    Date of Award To Be Inscribed  4a. Rank        4b. Last Name                           4c. First Name                         4d. Middle Initial                          4e. Meets award criteria YES NO   (Must be a member of SCRA). 4f. SCRA Member YES NO 5.    Date of Award To Be Inscribed  5a. Rank        5b. Last Name                           5c. First Name                         5d. Middle Initial                          5e. Meets award criteria YES NO   (Must be a member of SCRA). 5f. SCRA Member YES NO   3. Justification for award:        By checking this box, I agree that I have reviewed the Award Criteria and the above nominee meets the requirements.  If the award is being submitted within 30 days of the required date for the award, I understand that a 25% processing fee is required. I understand that the award has to be purchased first and a PayPal transaction number entered above or the award request application will not be processed.     Purchase award at the SCRA Store    Questions Contact Us Signal Corps Regiment Association National Office 4570 Dewey Drive Martinez, Georgia 30907 PHONE: (706) 364-1755 FAX:   (706) 364-1756 E-mail us: Manager: Mr. Bryan Tuschen Contact us for more info