Firefighter/Law Enforcement Heroism Form

Max. file size: 256 MB.
Date of Rescue/Incident:(Required)
Are any other citations (or other state/national awards/honors) being recommended in connection with t(Required)
Was member alone?(Required)
Was SCBA worn (if application)?
Was a charged hose line in position to protect member performing the rescue (if applicable)?
Was complete protective clothing worn (turnout, ballistic vest)?(Required)
Was member injured?(Required)
Was victim injured?(Required)
Was the victim removed from:(Required)
How was victim removed from premises?(Required)
Was a ladder used in this rescue?(Required)

Victim Aided