U.S. Army Human Resources Command



SAMPLE FORMAT – MOVSM RecommendationMilitary Outstanding Volunteer Service MedalName (Last, First M.I.): Doe, John A. Rank: PFC Unit: 1/41 INF, 1st CAV, Fort Hood, TXPeriod for Which Nominated: 20130117 – 20160523.Description of Community Service: Served as the 442nd Troop Leader for the local Boy Scouts of America organization located in Killeen, TX. Weekly meetings with other Troop Leaders held on Friday evenings to assist in coordinated planning of organizational goals, activities, events, and fund raising. Troop holds weekly meetings on each Saturday for 5 hours from 9:00am to 2:00pm to train/test on tasks, provide community service for the local area and monthly fund raising events.(Provide data for each community activity support. No more than one activity required.)COMMUNITY ACTIVITY NAME ADDRESS PHONE POINT OF CONTACT Boy Scouts of America, 1234 Public Square, Killeen, TX (254)123-4567 Mr. GarrisonBrief Description of Mission and Population Service.Period of Service 20130117 – 20160523Brief Description of Service Rendered: Impact/Results/Achieved; Approximate Hours Contributed.Note: List additional community activities supported on plain bond paper in the above format.Total Hours Community Service This Period: 1200 hours.SUPERVISOR’S NAME GRADE DUTY TITLE SIGNATURE/DATEPublic, Jane A. E-6 Squad LeaderCommander’s Comments:Commander’s Certification:This individual performed outstanding volunteer service to the community of a sustained, direct, and consequential nature and is recommended for award of the Military Outstanding Volunteer Service Medal. His/her service throughout this period was MANDER’S NAME GRADE DUTY TITLE SIGNATURE/DATEHouston, Samuel B. O-3 Co CommanderApproval Authority: (Lieutenant Colonel or higher)APPROVED DISAPPROVEDAWARDING AUTHORITY NAME GRADE DUTY TITLE SIGNATURE/DATE ................
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