Application for the award

Information concerning the person proposed for mark of honour:

Name:

Date of Birth:

Address:

Zip code and city:

Phone:

Based on enclosed CV it is proposed the above mentioned person will be awarded
the Society of Security Strengthening medal:


Details of the person who suggests that the above-mentioned person receives a medal:

Name:

Date of Birth:

Address:

Zip code and city:

Phone:

Position:

Company / organization:

Place and date:


Curriculum vitae

Name of the person proposed for mark of honour:

1. Has been active in the profession during the period:

2. Held positions in the following periods:

3. Special efforts:

4. Other public service of importance:


Responsible for the accuracy of the given information:

Name:

Date of Birth:

Address:

Zip code and city:

Phone:

Position:

Company / organization:

Place and date:

Your Email

Your Message (optional):

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