NATO Medals are not US military medals, but foreign awards, and unlike the medals of America, they are presented by the authority of the North Atlantic Treaty Organization. There are currently ten versions of these military medals in existence. These military medals honor service in Yugoslavia, Kosovo, the Republic of Macedonia, Article 5 operations Eagle Assist and Active Endeavor, and Non-Article 5 NATO operations ISAF, Balkans, NTM-Iraq and Pakistan. In the USA, NATO medals authorized for wear include the NATO Medal for Former Yugoslavia, the NATO Medal for Kosovo Service, both of the Article 5 Medals, the Non-Article 5 medals for the Balkans and Afghanistan (ISAF), The NATO Meritorious Service Medal and the Macedonia NATO Medal and the Non-Article 5 Medal for service in Iraq, under the NTM-I.
There are some NATO medal versions that have special requirements. For U.S. Forces, eligibility for the Non-Article 5 Medal for the Balkans remains the same as those previous NATO medals with the exception of the dates of service. Military personnel entering the Balkans during or after January 2003 must provide 30 days of continuous or accumulated service to be eligible for the Non-Article 5 medal. Aircrew members will only be credited for one day of service for the first sortie flown during any day of the operation. Service members who are entitled to more than one NATO medal during the same period will only be awarded one NATO Medal. The NATO chain of command will deem which medal is appropriate.
NATO Medals for Service with ISAF are issued with the ISAF clasp for service in Afghanistan and the NTM-1 clasp for service in Iraq for NATO forces. However, for U.S. Forces the eligibility for the Non-Article 5 Medal for service with the ISAF are for members of units or staffs as set out in the Joint Operations Area taking part in operations in Afghanistan. The service must be a minimum of 30 days either continuous or accumulated, from June 2003 to May 2009.
The NATO Meritorious Service Medal is now authorized for wear on U.S. Military uniforms. These military medals and ribbons were first awarded in 2003 to commend NATO staff whose personal initiative and dedication went beyond their required duties to make a difference both to their colleagues, and to the North Atlantic Treaty Organization as a whole. There are several criteria taken into consideration in presenting these awards: the performance of acts of courage in difficult or dangerous circumstances; showing exceptional leadership or personal example; making an outstanding individual contribution to a NATO sponsored program or activity; or enduring particular hardship or deprivation endured while advancing the interests of NATO.
Different patterns are used to differentiate between all the various military ribbons and medals issued by NATO. All these military awards except the Macedonian medals have corresponding Campaign Clasps. However, the US prohibits wearing them and has authorized Service Stars to indicate additional awards of NATO medals. These NATO medals are normally worn below the Military Outstanding Volunteer Service Medal and above the Kosovo NATO Medal in the general order of precedence that has been established for the proper display of all military medals and ribbons. These military awards can be worn as traditional full size military medals and mini medals, military ribbons and lapel pins. They are available as traditional slide-on, full size military medals, mini-medals, and slide-on military ribbons. Nowadays however, more and more military service personnel are realizing the value to their career goals of always having their uniform decorations looking their best, and have turned to the slimmer and trimmer thin military medals and mini medals and the ultra thin military ribbons to provide them with the smartest looking military award displays possible.