Nomination Form (Deadline date:  extended to Feb. 28, 2018)

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* 1. Member nominee

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* 2. Award class:

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* 3. Person & title submitting nomination:

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* 4. Nominee's years with organization:

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* 5. Your phone number:

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* 6. Your email address:

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* 7. Provide a brief description of the project and/or program:

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* 8. Describe the issue or circumstance that let to this program:

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* 9. What makes this project and/or program unique or innovative?

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* 10. Identify the value added (i.e., increased safety, cost savings, service improvement, etc.) that were a result of project and/or program:

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* 11. Are there other noteworthy features of your project and/or program we should consider?

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* 12. How could this project and/or program be adapted by our members? Who else would benefit?

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