Completing the following questionnaire will further help ensure that the nominee is eligible for this category and will sere as the award nomination. Supporting material should be attached to this form.
Contact Information:
|
Person or group
(include contact name)
submitting nomination |
|
|
Phone/email |
|
|
Address |
|
|
City |
|
|
State/Province |
|
|
Zip/Postal Code |
|
|
Name of nominee |
|
|
Address |
|
|
City |
|
|
State/Province |
|
|
Zip/Postal Code |
|
|
Occupation |
|
|
Employer |
|
|
Title/position/phone/email |
|
Questions:
1. Is the nominee a current member of the Society?
[ ] Yes
[ ] No (If no, the nominee is NOT eligible for this award)
2. Is the nominee a current member of the Society’s Board of Directors?
[ ] Yes (If yes, the nominee is NOT eligible for this award)
[ ] No
3. Has the nominee been a Society member for 10 years?
[ ] Yes
[ ] No (If no, the nominee is NOT eligible for this award)
4. Has the individual made contributions to the progress of the Society beyond the chapter level?
[ ] Yes
[ ] No (If no, the nominee is NOT eligible for this award)
5. Please check and describe the extent to which the nominee’s professional achievements have been recognized;
[ ] Only statewide/province-wide (STOP, the nominee is NOT eligible for this award because the professional achievements are not widely recognized over a large enough area.)
[ ] Multi-state/multi-province
[ ] Nationwide
[ ] International
6. Briefly explain how the nominee’s professional excellence and achievements relate to fostering the science and art of natural resource conservation.
Supporting Material:
Summarize information about the nominee’s education, biographical and employment history, honors, and other information, which relates to and supports the nomination. Provide specific information on professional achievements (e.g. publications or projects undertaken.) Provide details of involvement in the Soil and Water Conservation Society, at the Chapter and beyond the Chapter level. List awards received from the Society and other organizations. The nomination must be accompanied by a Professional Curriculum Vitae.
Award nomination supporting material may be emailed to: sueann.lynes@swcs.org. If emailing, you may fax the signed petition to 515-289-1227. You may also submit the Award nomination by U.S. Postal Service (1 copy only) to: SWCS-Awards, 945 SW Ankeny Rd., Ankeny, IA 50023. All nominations must be received by December 12. All forms of submission will receive a confirmation of receipt. Late nominations will not be considered.
