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Golden Manhole Award Society Nomination

Please complete all required fields!

Please complete the following nomination form and any supporting documentation by July 1.

Fields marked with an (*) are required.

Section A: Nominator

Your Name(*)

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Email(*)

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Address(*)

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City(*)

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State(*)

Please SelectAlabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Florida Georgia Hawaii Idaho IllinoisIndiana Iowa KansasKentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri MontanaNebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon PennsylvaniaRhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming

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Zip(*)

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Section B: Nominee

Full Name(*)

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Job Title(*)

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Employer(*)

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Address(*)

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City(*)

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State(*)

Please SelectAlabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Florida Georgia Hawaii Idaho IllinoisIndiana Iowa KansasKentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri MontanaNebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon PennsylvaniaRhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming

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Zip(*)

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Supporting Materials

Evaluation Criteria

1. Years of experience and significant participation in one or more areas: Operations, Maintenance, Design, Education, Training, Certification, Management, and/or Planning of Sewer Collection Systems.
2. Involvement in promoting the professional recognition of the collection systems field.
3. Participation in the KWEA Collection Systems Committee (helpful, but not required).
4. Papers or articles accepted by state, regional, or national publications as well as technical presentations at professional conferences.

Please list the significant contributions the candidate has made that promote pride and safety in the workplace, teamwork, education, and the promotion of professionalism in the collection systems field.

If preferred, you may upload supporting materials at the bottom of this page.

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Supporting Materials

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