Sponsored by: Hawkeye on Safety Planning Committee
Presented at the 5th Annual Hawkeye on Safety Conference
Thursday, October 11, 2018
Submission Deadline: July 16, 2018
 
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 annually recognizes an individual who is dedicated to making their workplace safer. Winners will receive a plaque and recognition at the 5th Annual Hawkeye on Safety Conference 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.
Nominee Name

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* 1. Nominee Name

Nominee's Employer

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* 2. Nominee's Employer

Nominee's Position/Title

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* 3. Nominee's Position/Title

Years of Service to Employer

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* 4. Years of Service to Employer

Describe why nominee deserves this award. Include examples and specifics.

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* 5. Describe why nominee deserves this award. Include examples and specifics.

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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* 6. 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.

DOCX, DOC, JPEG, GIF, JPG, PDF, PNG file types only.
Choose File
No file chosen
List references or contacts that may be useful if the committee needs additional information:

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

Additional information may be requested from the submitter as the committee narrows their selection of qualified candidates.

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