Long term service award Please enable JavaScript in your browser to complete this form.Please enable JavaScript in your browser to complete this form.NomineeNominee Name *Award Category *101520303540Honorary membershipLifetimeAddress *City *Province *Postal Code *Membership number *Present Component *Direct Charter LocalAgriculture UnionCanada Employment and Immigration UnionCustoms Immigration UnionUnion of Environment WorkersGovernment Services UnionUnion of National EmployeesNational Health UnionUnion of Canadian Transportation EmployeesNatural Resources UnionNunavut Employees UnionUnion of National Defence EmployeesUnion of Northern WorkersUnion of Postal Communications EmployeesUnion of Safety and Justice EmployeesUnion of Taxation EmployeesUnion of Veterans Affairs EmployeesYukon Employees UnionPresent local *Service record Record in chronological order positions held in PSAC over 10 year period (breaks not to exceed three months). If more than three months, an explanation is required. Complete one line for each position held. Service Record(from, to, position held, local/component/DCL/explanation)Other informationNominatorNominator Name *Nominator Position *Nominator email *SeconderSeconder Name *Seconder Position *Seconder Email *Verifier The person from the component national office or Directly Chartered Local supporting this nominationVerifier Name *Verifier Position *Verifier email *Approval Component President or REVPApproval Name *Approval Position *Approval Email *Submit
