Mercury Medal of Achievement Application

POC/Nominator (Your) Rank:

POC/Nominator (Your) Name: *

First

Last

POC/Nominator Email *

POC/Nominator Phone No:

SCRA Chapter

Awardee Rank: *

Awardee Name: *

First

Last

Suffix:

Rank & Name for Certificate: *

Please write rank & name EXACTLY as it is to appear on the Award Medal & Certificate.
PLEASE NOTE: FULL COST OF AWARD WILL BE CHARGED FOR REPLACEMENTS AS A RESULT OF MISSPELLED NAME OR INCORRECT RANK. ($25 OFF IF MEDAL IS RETURNED)

Awardee SCRA Member ID: *

Membership in the SCRA is required to receive this award. You may purchase a gift membership for the nominee if they are not a current member.

Award Presentation Date: *

This date will be PRINTED on the certificate.
A $25 Fee will be applied to awards when payment is made within 30 days of presentation date.

Award Presentation Event:

Examples: Signal Ball, Retirement Ceremony, etc.

Approval Method: *

I Have Prior Authority Approval
I Need National Approval

This award can be approved by a COL/O6 or above of the Regiment who is also a member of the SCRA.
It may also be approved by the president of your local chapter.
The National SCRA has the authority to review ALL submitted awards for eligibility prior to processing.

Memorandum/Justification Letter (PDF preferred) *

Click or drag a file to this area to upload.

Additional Nomination Documentation (Optional)

Click or drag a file to this area to upload.

Delivery Option: *

Pick Up (Ft. Eisenhower/Augusta Area)
Ship Award

Shipping address will be required when payment is made.

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