Life Saving Award Recognition - Maryland State Firemen's Association

This recognition is presented to the member or members of your company/department that responds to a life saving call that does not qualify for the Josiah A. Hunt, M.D. (EMS Person of the Year) Award. List the member or members, date of event and nature of event.

It is extremely important that you spell the name correctlsy, as this is exactly how it will be printed on the certificate. Be sure to double-check punctuation (commas between last name and Sr., Jr., etc. where applicable).

These Certificates will be made available at the Annual MSFA Convention . Presented on stage during the Convention only when program time permits.

Certificate of Recognition Request Form

Your Name*
First Last
Please provide us with your name so that we know who to contact if there is a question.
Department Name*
County
Your Email*
Your Phone
Date of Incident*
MM slash DD slash YYYY
List Participating Members (Separated by Commas)*
Nature of Event/Incident Details*
Phone
This field is for validation purposes and should be left unchanged.

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Life Saving Award Certificate of Recognition

Certificate of Recognition Request Form

Maryland State Firemen's Association