Cross of Valour ( Canada ) The Cross of Valour ( ) is a decoration that is , within the Canadian system of honours , the second highest award ( superseded only by the Victoria Cross ) , the highest honour available for Canadian civilians , and the highest of the three Canadian Bravery Decorations . Created in 1972 , the medallion is presented to individuals , both Canadians and foreigners , living and deceased , who have performed acts of the most conspicuous courage in circumstances of extreme peril and grants recipients the ability to use the post - nominal letters " CV " . History . The Cross of Valour was conceived of as a replacement for the Order of Canada ' s Medal of Courage , which had never been awarded since its creation in 1967 . On the advice of her headed by Prime Minister Pierre Trudeau , the Cross of Valour was initiated on 1 May 1972 by Queen Elizabeth II , and presented for the first time on 20 July of the same year . Prior to 1967 , the equivalent medal that Canadians received was the George Cross , of which ten were awarded in Canada : eight military , one merchant navy , and one civilian . The Cross of Valour became the centre of a controversy in 2007 , when it was announced from the Chancellery of Honours at the Governor General of Canada ' s residence , Rideau Hall , that deceased Cobourg , Ontario , police constable Chris Garrett would not be awarded the honour . Garett died on duty after an individual lured him with a false 9 - 1 - 1 call and then cut his throat ; however , Garett , as he was dying , shot and disabled the assailant , thereby preventing other planned attacks . But , because Garett ' s nominator waited until the trial for the constable ' s murderer was concluded , the application arrived at Rideau Hall eight months past the stipulated two - year deadline . After a public outcry , the Governor General - in - Council adjusted the rules of application for the Cross of Valour . Design . The medal is a cross of four equal limbs rendered in gold , with the obverse enamelled in red and edged with gold , and bearing at the centre a gold maple leaf surrounded by a gold laurel wreath . On the reverse is the Royal Cypher of the reigning Canadian sovereign and a crown above , on the upper arm , while the words " VALOUR • VAILLANCE " are etched below , extending along the upper edge of the two lateral arms of the cross . The recipient ' s name and the date of the incident for which they are being honoured are engraved underneath the motto . This medallion is worn on the left chest , on light crimson ribbon wide : for men , hung from a medal bar , and for women , on a ribbon bow pinned to the left chest ; a miniature cross may be worn on the ribbon bar in undress . Should an individual already possessing a Cross of Valour be awarded the medal again for subsequent valourous acts , he or she is granted a gold maple leaf to be carried on the same ring from which the original cross is hung ; no bars have been issued to date . Eligibility . Anyone may nominate or be nominated for receipt of the Cross of Valour ; the incident need not take place in Canada , but Canadian people and / or interests must be involved . The decoration may be awarded posthumously , though nominations must be made no later than two years following either the act of bravery itself or the conclusion of any coroner ' s or court ' s inquest into the events for which the person was nominated .