Every year the New Year's Honours List and the Birthday Honours List are announced in the London Gazette, and summonses are sent to the recipients requesting them to attend an investiture at Buckingham Palace. On average 14 investitures a year are held at Buckingham Palace, and once every five years an investiture is held at the Palace of Holyroodhouse in Scotland. The Queen or a senior member of the royal family officiates.

At Buckingham Palace investitures take place in the Ballroom, and about 135 people are invited to attend to receive their orders, decorations and medals, which are presented by The Queen herself. At the start of the ceremony The Queen enters the room flanked by two Gurkha orderly officers, a tradition instituted by Queen Victoria. The Queen herself pins the decoration on the recipients. Those who are receiving a knighthood kneel on an Investiture stool before The Queen. She uses the sword that belonged to her father, King George VI, to dub the knight.

Only the recipients of the British Empire Medal do not receive a summons to an investiture, owing to the very large numbers involved, and recipients instead receive their decorations from their Lord Lieutenant, or in the case of military medals, from a General Commanding Officer.

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