The "Distinguished Service Medal" of the Civil Air Patrol is awarded for "conspicuous performance of outstanding service in a duty of great responsibility where the position held and results obtained reflect upon the accomplishments and prestige of CAP on a national scale." The duties for which this medal are awarded must be extremely difficult and of importance to the national mission of the CAP. This is the highest award for service given by the CAP. Any member may nominate deserving cadets or officers for the award. All nominations are approved by the CAP National Headquarters. If the act of service is deemed to be important at the region level or wing level, the member is generally recommended for the Exceptional Service Award or the Meritorious Service Award. This award consists of the medal itself along with a ribbon and certificate that accompanies the decoration. A miniature medal is available for senior members to wear on their mess dress uniforms.