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The NATO Medal is an international military decoration which is awarded to various militaries of the world under the authority of the North Atlantic Treaty Organization (NATO). It is manufactured by Eekelers Centini Intl, of Hemiksem, Belgium.

The NATO Medal was first established in 1996 to recognize individuals who had served in the Implementation Force (IFOR) as part of Operation Joint Endeavor in Former Yugoslavia. A new ribbon was established in 1999 for participants in Operation Allied Force in Kosovo. As NATO operations became more common, different ribbons were established for each operation. In early 2003 NATO settled on only three ribbon styles one for the NATO Meritorious Service Medal, one for Article 5 operations, and one for non Article 5 operations. Participation in specific operations is distinguished by bars worn on the ribbons with the name of the operation. This change affects those who began a tour of duty after 2 December 2002. As a result, an individual who began his or her tour of duty in one of the Balkan NATO operational areas after 2 December 2002 will qualify only for the Non Article 5 medal for the Balkans.

United States Armed Forces regulations do not permit the wearing of operation bars on the NATO Medal ribbon. Instead, the recipient wears the ribbon without a bar attached to it. In the event that a US service member is entitled to more than one NATO medal, they wear the ribbon of the first NATO medal they received and the appropriate number of bronze service stars to indicate the number of NATO medals they have been awarded. For example a service member who served in Former Yugoslavia, Kosovo and ISAF in Afghanistan would wear the Former Yugoslavia ribbon with one bronze service star to denote the award of the second NATO medal. In contrast, the Armed Forces of the United Kingdom permit a service member to wear most of the NATO medals they are entitled to, provided that the operation the NATO Medal is awarded for is not recognized by another medal awarded by the United Kingdom. The NATO Africa medal and NATO Training Mission Iraq may not be worn by UK service persons.

There are currently fourteen versions of the NATO Medal in existence, for service in the former Yugoslavia, Kosovo, North Macedonia, two for service during Article 5 operations (Eagle Assist, Active Endeavour), and eight for Non Article 5 NATO operations (International Security Assistance Force Afghanistan (ISAF), Resolute Support, Balkans, NATO Training Mission Iraq (NTM I), Africa, AMIS, OUP Libya, and Pakistan). In addition, there are corresponding clasps for operations such as ISAF, Kosovo, the former Yugoslavia, NTM I, and clasps designating Article 5, and Non Article 5 designations. There is also a NATO Meritorious Service Medal, with a "Meritorious Service" clasp as well. However, U. S. military personnel do not wear the clasps on the NATO Medals, since the U. S. has its own devices that are used instead.

The 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 organisation. 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 programme 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. For Canadian and U. S. military members, the NATO MSM is considered a foreign personal decoration and would be placed in the order of receipt within that category, followed by foreign unit awards, then non U. S. service and campaign awards (such as the standard NATO Medal). This arrangement may lead to some U. S. military personnel with the NATO MSM separated by the United Nations Medal from the standard NATO Medal. As it is a personal foreign decoration, the NATO MSM is the only NATO medal that can be worn concurrently with the standard NATO Medal.

To differentiate between the versions of the NATO Medal, a different ribbon pattern scheme is used for each of the decorations. The NATO Medal for Yugoslavia service consists of a blue ribbon with two thin white stripes on each side, very similar in appearance to the United Nations Medal. The NATO Medal for Kosovo service appears as a mixed blue and white stripped ribbon, with white stripes on the side as well as a wide white central stripe. The NATO Medal for North Macedonia service appears as a blue and white mixed ribbon with four white stripes. The Article 5 NATO Medal for Operation Eagle Assist has a blue background with a thin central golden stripe surrounded by white stripes. The Article 5 Medal for Operation Active Endeavour has a blue background with two thin golden colored stripes surrounded by white stripes. The Non Article 5 Medal for the Balkans operations consists of a blue background with a central silver stripe surrounded by white stripes. The Non Article 5 Medal for both ISAF and NTM I operations consists of a blue background with two silver stripes surrounded by white stripes. The NATO Meritorious Service Medal consists of a blue background with gold, silver and three narrow white stripes on each outer most portion of the ribbon, and the medallion color is changed from bronze in appearance to a silver medallion for this medal only. All medals except North Macedonia's NATO Medal have corresponding campaign clasps, however some militaries (such as the United States) prohibit the wearing of the medal with a clasp and instead authorize service stars for wear on any NATO Medal while wearing any US military uniform (although the various clasps may be accepted from NATO and retained by the service member as a memento). For the U. S. military, a bronze service star indicates additional awards of the service and mission related NATO Medals. As of May 2013, only the NATO MSM ribbon bar (as a personal foreign decoration) and the basic NATO ribbon (as a non US service and campaign medal) may be worn for U. S. services (at least this is true for the U. S. Army). The reverse of the medals state "IN SERVICE OF PEACE AND FREEDOM" in English and French, as well as the full name of NATO in English and French. The ribbon bar and suspension bar are both chiefly blue, specifically Reflex Blue on the Pantone Matching System.

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. Those members entering the Balkan theatre on or after 1 January 2003 will be eligible for the Non Article 5 medal. The service must be 30 days either continuous or accumulated. Aircrew members will accumulate one day of service for the first sortie during any day of the operation. Additional sorties on the same day will receive no further credit. The Balkans area is delineated as the political boundaries and airspace of Bosnia and Herzegovina, Croatia, Yugoslavia (including Kosovo), the Republic of North Macedonia, and Albania, based on the detailed description contained in the SFOR, KFOR, and Task Force Fox Operational Plans. 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. This medal may also be awarded with the "ISAF" clasp for service in Afghanistan, as well as the "NTM I" clasp for service in Iraq with NATO forces. For U. S. forces the eligibility for the Non Article 5 Medal for service with the ISAF is thus: those who are members of units or staffs as set out in the Joint Operations Area taking part in operations in Afghanistan. The area of eligibility is delineated by ISAF's political boundaries. The service must be a minimum of 30 NATO campaign medals where a British decoration has not been issued, such as the award for Operation Unified Protector, may be worn. On 24 July 2012, the United States Department of Defense announced that NATO medals for operations in Libya and Africa have been approved for acceptance and wear by eligible U. S. service members and DOD civilian personnel.