Skip to content

Use this form to request either the Medical Proficiency Award or the Advanced Medical Proficiency Award. Please use Chrome, Firefox or Edge to submit this form. Internet Explorer may not work. correctly.
click here for the privacy policy.


Nominator Information

Fill in the following information about yourself.

Award and Qualification

Please choose the award you wish to have the nominee receive and then type the reasons you feel that the marine is qualified for the award. Special Note, do not use an apostrophe in this section. It will cause an error during submission.

For the Medical award supporting documentation must be submitted as proof that the requirements for the requested award has been met. *

Please note that file names cannot have a space in it. Supported formats are *.jpg, *.png, *.bmp, *.gif, *.pdf, *.txt, *.rtf