The Most Excellent Order of the British Empire is an order of chivalry established on 4 June 1917 by George V of the United Kingdom. The Order comprises five classes in civil and military divisions. In descending order of seniority, these are: Only the highest two ranks automatically cause an individual to become a knight or dame, an honour allowing the recipient to use the title "Sir" (male) or "Dame" (female) before their first name (though men can be knighted separately from this and other Orders of Chivalry). Honorary knighthoods, given to individuals who are not nationals of a realm where Queen Elizabeth II is Head of State, permit use of the honour as a post-nominal but not as a title before their name. Awards in the Order of the British Empire in the Commonwealth Realms were discontinued with the establishment of national systems of honours and awards such as the Order of Australia, the Order of Canada and the New Zealand Order of Merit. Foreign recipients are classified as honorary members of the Order they receive, and do not contribute to the numbers restricted to that Order as full members do. There is also a related British Empire Medal, whose recipients are not members