NATO Meritorious Service Medal (MSM) was first awarded in 2003 to commend NATO staff whose personal initiative and dedication went beyond their duty to make a difference both to their colleagues, and to NATO as an organization. The Medal is the personal award of the Secretary General of NATO, who signs each citation. Although authorized up to 150, fewer medals are awarded each year and it remains the only significant award for individual personal effort for NATO staff; this Medal can be awarded to military and civilian staff alike. When assessing nominations for the award, there are several criteria taken into consideration: 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 in the interest of NATO. The NATO Meritorious Service Medal is now authorized for wear on U.S., Canadian and British military uniforms.