Awards Submission Form

I hereby nominate *

Please enter the name of the plan; project, program, practice; or leader being nominated.0 / 500

Award Category *

Responsible Party(ies)

If a plan, project, program or practice please name the responsible organization(s).

Others who merit recognition (if any)

Please give the Name, Title and Organization of other organization(s) or person(s) (if any) who merit recognition:

Nominee's First Name *

Nominee's Last Name *

Nominee's Title *

Nominee's Company/Organization *

Organization's Street Address *

Apartment, suite, etc

City *

State/Province *

ZIP / Postal code *

Country *

Nominee's Email Address *

Nominee's Phone *

Nominator's First Name *

Nominator's Last Name *

Nominator's Organization *

Nominator's Street Address *

Apartment, suite, etc

City *

State/Province *

ZIP / Postal code *

Country *

Nominator's Email Address *

Nominator's Daytime Phone *

555-555-1212

Certification *

I certify that the nominated work was done by the party(ies) credited and meets all eligibility requirements. I understand that any entry that fails to meet submission requirements may be disqualified. (You must be authorized to represent those credited.)

I hereby certifyI do not agree

Attach a Narrative *

Narrative (1,200 words maximum, roughly two pages single spaced) in Microsoft Word or PDF format including a SUMMARY description of the nomination plus a JUSTIFICATION of how the nomination meets each of the published criteria for the category in which the award is sought. This file should be no larger than 5MB.

Attach Support Letter(s) *

Submit at least two (2) but no more than five (5) one-page letters of support in a PDF format or JPG file. Letter(s) should offer support for the value of the nominated effort. Letter(s) may not be written by the nominator of the submission, by the nominated individual or by anyone who directly worked on the project.

Attach copy of a Nominated Document

Upload a complete copy of a nominated document in PDF format, or a reliable, working URL link to the complete document on a publicly-accessible web site. This file should be no larger than 5MB. REQUIRED for all plans and for projects (including student projects), programs, and practices that include a published document, report, guidelines, etc.

Attach Support Document(s) if any

Nominations may include newspaper articles or other support documents testifying to the nominated effort or person. Please attach a single PDF file of any supporting documents.

Supporting Images

Attach additional images in a single file if needed

Captions (IF you have submitted images without captions above)

IF your images submitted above DO NOT CONTAIN CAPTIONS, please attach a Word document giving us a caption for each photo/image, between 15-25 words per caption.

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Awards Submission Form

Award Submission Form