WPOA AWARD NOMINATION FORM
REQUIREMENTS FOR NOMINATION
(CHECK APPROPRIATE BOX)

The AWARD FOR PROFESSIONAL ACHIEVEMENT is given to a woman
who is a California Police Officer, for an outstanding accomplishment that brings recognition
and furthers women in the law enforcement profession. Her performance should be over a
significant period of time, in a manner superior to that of others, in terms of devotion to duty,
skill, or originality. It can be a performance of service to the community, an operational
activity, a department duty or accomplishment, or for someone who has served as a role model.

PLEASE SPECIFY WHICH PROFESSIONAL ACHIEVEMENT CATEGORY :

[   ] Management (Lt. and above)   [   ] Line Officer (Sgt. and below)

[   ] THE AWARD FOR VALOR is given to a woman who is a California Peace Officer,
for an action she performed in a manner beyond that which is normally expected of her, and
such action exposed her to great personal risk.

[   ] THE WPOA MEMBER MERIT AWARD is given to a WPOA member in
recognition of his or her dedication and service to the Women’s Peace Officer’s Association
of California. Candidates must be nominated by WPOA members.

SCREENING: All nominations must be postmarked no later than March 30 of any given year.
The nomination forms will be reviewed by the WPOA Executive Board. The awards will be
presented at the June Training Conference.

PLEASE SEND NOMINATIONS TO:

WPOA  P.O. Box 589  Sacramento, CA 95812

APPLICATION SUBMITTED BY:

Name:____________________________________Position:__________________________
Agency of Professional Affiliation:_____________________________________________
Address:__________________________________________________________________
City:____________________________________State:___________Zip:______________
Telephone:___________________________e-mail:________________________________
Supervisor Endorsement (Optional):____________________________________________

NOMINEE: (ATTACH ADDL. PAGES SUPPORTING REASONS FOR NOMINATING)

Name: _________________________________ RANK: __________________________
Agency:_________________________________________________________________
Address:_________________________________________________________________
City:___________________________________State:___________Zip:______________
Telephone:___________________________e-mail:______________________________