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Air Force Combat Action Medal

The Air Force Combat Action Medal (AFCAM)[3] is a relatively new medal created for the United States Air Force in March 2007 to recognize Air Force members for active participation in ground or air combat.
Nomination of the award of the AFCAM will be restricted to members of the U.S. Armed Forces who on or after 11 September 2001 were under any of the following conditions:
-Deliberately go into the enemy's domain (outside the wire) to conduct official duties, either on the ground or in the air, and have come under enemy fire by lethal weapons while performing those duties, and are at risk of grave danger.
-While defending the base (inside/on the wire), and must have come under enemy fire and engage the enemy with direct and lethal fire, and are at risk of grave danger.
-Are personnel in ground operations who actively engage the enemy with direct and lethal fires also may qualify even if no direct fire is taken, as long as there was risk of grave danger and meets other criteria.

The AFCAM is the only U.S. military award to have a diagonally patterned ribbon, much like the British Distinguished Flying Cross and Netherlands Airman's Cross. The AFCAM service ribbon has five stripes.