Golden Manhole Award Application pdf

GOLDEN MANHOLE AWARD SOCIETY NOMINATION FORM DEADLINE: May 20 of each calendar year. INSTRUCTIONS: 1. All nominations forms must be submitted in triplicate (3 copies), including all attachments. 2. Nominators must use the attached form other formats will not be accepted. 3. Submitted material will not be returned to sender. 4. Nominations shall be submitted to the named representative of each section by May 20 of each calendar year. REQUIREMENTS: Significant participation in one or more of the following areas: Operations, Maintenance, Design, Education, Training, Certification, Management and Planning of Sewer Collection Systems. EVALUATION CRITERIA: Induction will be decided by a vote of the committee, which will be comprised of the previous recipients of the Golden Manhole Award. The committee will use the following criteria to select a nominee for the award. The recipient shall meet three out of the four criteria listed below. 1. Years of experience and significant participation in one or more of the areas listed in the above section titled REQUIREMENTS; 2. Involvement in promoting the professional recognition of the collection system field; 3. Member in good standing of the Ohio Water Environment Association; 4. Active involvement in the Ohio Water Environment Association Collections Committee. OTHER: The selection committee recognizes and honors separately, both the inductees and their employers for their combined contributions, which promotes increased professionalism in the collection systems field. SUBMIT TO: Golden Manhole Society Selection Committee c/o Dianne M. Sumego QUESTIONS PLEASE CALL: Dianne M. Sumego, ARCADIS, Suite 2400, 520 South Main Street, Akron, Ohio 44311-1010, 330-434-1995 (telephone), 330-374-1095 (fax) or email dsumego@arcadis-us.com [2007] NOMINATION FORM GOLDEN MANHOLE AWARD SOCIETY TO BE COMPLETED BY NOMINATOR I. NOMINATOR: A. Name: ___________________________________________________ Address: ___________________________________________________ Telephone Number: ___________________________________________________ E-Mail Address: ___________________________________________________ II. NOMINEE B. Name: ___________________________________________________ Employer: ___________________________________________________ Title: ___________________________________________________ Address: ___________________________________________________ Telephone Number: ___________________________________________________ E-Mail Address: ___________________________________________________ III. List the significant contributions the candidate has made that promote the pride and safety in the workplace, teamwork, education and the promotion of professionalism in the collection systems field. Please provide additional attachments and information as necessary. ______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ GOLDEN MANHOLE AWARD SOCIETY