Long term service award nomination form

To be considered by the NBoD, nominations must be submitted 30 days prior to any NBoD meetings – complete with endorsement from the Component or REVP – to the PSAC Executive Office.  Nominating bodies require time to review applications, so earlier submission is advisable.  


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. 

(from, to, position held, local/component/DCL/explanation)




The person from the component national office or Directly Chartered Local supporting this nomination


Component President or REVP