Completing the following questionnaire will further help ensure that the nominee is eligible for this category and will serve as the award nomination. Supporting material should be attached to this form.

Contact Information:

Questions:

1. Is the nominee a current member of the Society?
            [   ]  Yes            
            [   ]  No

2. Is the nominee a current member of the SWCS Board of Directors, SWCS Employee or Awards Committee?
            [   ]  Yes            
            [   ]  No (If YES, this individual is not eligible)

3. Is the nominee engaged or previously engaged in employment for which the principal responsibility is personally providing direct assistance to landowners and/or communities to conserve soil, water, and related natural resources on their property or in their communities?
           [   ]  Yes            
           [   ]  No  (If NO, this individual is not eligible)

4. Describe the nominee’s effectiveness, dedication, commitment and creativity in providing conservation technical assistance resulting in conservation being applied to the land.  The write-up should emphasize showing the results of plans as outlined in criteria above.

Supporting Material:

Attach additional pages as needed to complete your responses to the above questions. Summarize information about the nominee’s education, biographical and employment history, honors, and other information which relates to and supports the nomination.

Award nominations may be submitted by email to: sueann.lynes@swcs.org or by U.S. Postal Service to SWCS-Awards, 945 SW Ankeny Road, Ankeny, IA 50023-9723). Nominations must be received by December 12. Both forms of submission will receive a confirmation of receipt.Late nominations will not be considered.