Please complete all required fields! Please complete the following nomination form and any supporting documentation by August 1. Fields marked with an (*) are required. Your Name(*) Invalid Input Address(*) Invalid Input City(*) Invalid Input State(*) Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa KansasKentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Invalid Input Zip(*) Invalid Input Phone(*) Invalid Input Email(*) Invalid Input Section B: Nominee Full Name(*) Invalid Input Job Title(*) Invalid Input Employer(*) Invalid Input Phone(*) Invalid Input Address(*) Invalid Input City(*) Invalid Input State(*) Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa KansasKentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Invalid Input Zip(*) Invalid Input Supporting Materials Evaluation Criteria Must be a member of the Water Environment Federation. Candidate must be employed at an educational facility laboratory, industrial, commercial, or municipal laboratory which performs wastewater-related analysis, and must have direct analytical responsibilities. Candidates are eligible for this award only once. Qualifying criteria may include: Membership and involvement in professional associations. Examples: Water Environment Federation Committees, Standard Methods Joint Task Groups, MA committees and conferences and conference activities. Outstanding efforts in the area of wastewater and environmental aquatic analysis, including such items as innovative sampling techniques or solutions to a treatment, analytical or environmental problem. Involvement in community activities or public relations. Presentations at professional conferences, meetings, etc. relevant to water quality analysis. Professional certifications. Continuing education. Contributions that have been beneficial to the nominees facility. Unusual initiative or performance "beyond the call of duty. Please list reasons why the candidate is deserving of this prestigious award. In addition, please upload a one-page biography for the candidate. Invalid Input Supporting Materials Invalid Input Supporting Materials Invalid Input (*) Invalid Input
