Email Kansas Fire Department Meritorious Awards Nomination Form I would like to commend the actions of: Rank and Full Name * Additional Awards Recommendations (Ranks and Full Names) Incident Type * Structure Vehicle Other Date of Incident Location of Incident Incident Number Nature of Incident Responding Company #'s Brief Description of Situation * Name of person making rescue Unit Number Was assistance required to remove victim? Yes No Incident Commander Company Officer Additional responding units Conditions upon arrival Were hose lines charged Yes No Was protective clothing worn Yes No Was ventilation made Yes No Was SCBA used Yes No Was nominee hospitalized Yes No Was situation hazardous to the rescuer Yes No How far did rescuer enter structure End result of damage Describe nominees actions Your Name
