VETERANS INCENTIVE AWARDS 
	NOMINATION FORM

NAME_______________________________  		NAME______________________________
                                (Nominee)							     (Nominator)
TITLE__________________________________	            TITLE_________________________________
	   (DVOP, LVER, Other One-Stop Staff)
	
ONE-STOP_______________________________	            ONE-STOP_____________________________

ADDRESS________________________________	           ADDRESS______________________________

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TELEPHONE____________________________              TELEPHONE___________________________

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	(Check Applicable Activities)

1.	Productivity

____Veterans/Disabled Veterans Entered Employment	____Placement of VR&E Special Disabled Veterans

____Enrollment of Veterans/Disabled Veterans in Training	____Placement of Homeless Veterans

____Other

Justification Narrative
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2.	Veterans’ Advocacy

____Veterans’ Stand Downs 		____TAP Programs	_____Employer Marketing

____Veterans’ Homeless Programs	____ Veterans' Job Fairs 

____ Veterans' Grant Awards (Homeless Veterans' Reintegration Program, Veterans' Workforce 

         Investment Program, etc.) ____Community Involvement (Veterans’ Organizations, etc.)

____Personal Achievement (letters of appreciation, receipt of awards, etc.) ____Special Projects ____Other

Justification Narrative
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3.	Other (Any item of significance not cited above)

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