Sponsored by: Hawkeye on Safety Planning Committee
Presented at the 4th Annual Hawkeye on Safety Conference
Wednesday, September 20, 2017
 
Successful workplace safety is the commitment and willingness of every individual to pursue a safe, healthful, and environmentally sound work place. The Hawkeye on Safety conference committee would like to recognize employers or individual employees who are dedicated to making their workplace safer. Winners will receive a plaque and recognition at the 4th Annual Hawkeye on Safety Conference on September 20, 2017 in Coralville, Iowa. Additionally, they will be given an opportunity at the conference to present the safety information that was given to the committee as application for the award.

Criteria:
Nominees must satisfy at least 1 or more of the following 5 criteria:
  1. Implementing a safety program in their workplace.
  2. Taking an active role and being a strong advocate for safety and health.
  3. Demonstrating significant improvement over previous conditions
  4. Consistently maintaining a good safety program over a number of years.
  5. Making an extra effort to improve or correct a specific aspect of safety within the workplace.

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* Name of Nominee:

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* Nominee's Employer:

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* Nominee's Position/Title:

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* Years of service to employer:

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* Describe why nominee deserves this award. Include examples and specifics. You are welcome to submit documents and/or photos to support your nomination, if desired or applicable.

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* You are welcome to upload files to support your nomination. These could be photos of safety innovations and improvements, PDFs of data showing the success of a safety program, or a Microsoft Word file giving more information on your nominee's work. Note that no supporting documents are required. This step is optional. The file size limit is 16MB.

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* List references or contacts that may be useful if the committee needs additional information:

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