Awards Program Candidate Information Form Award Name*Select AwardAlfred E. Peloquin AwardArthur Sidney Bedell AwardAsset Management Excellence AwardBiosolids Management AwardClair N. Sawyer AwardCommittee Service AwardDiversity, Equity, and Inclusion AwardE. Sherman Chase AwardElizabeth Cutone Executive Leadership AwardEnergy Management Achievement AwardFounders AwardGeorge W. Burke, Jr. Safety AwardGreen Steps Sustainability AwardLaboratory Analyst Excellence AwardOperator AwardPaul Keough AwardWilliam D. Hatfield AwardYoung Professional AwardYouth Educator AwardCandidate's Name (as it will appear on award)* Candidate's Title* Candidate's Company/Affiliation* Candidate's Telephone*Candidate's Email Candidate's Mailing Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Swaziland)EthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaRéunionSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth GeorgiaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan Mayen IslandsSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Sponsor's Name (name of committee, state association, individual, etc.)* Sponsor's Company/Affiliation* Sponsor's Telephone*Sponsor's Email* Please verify your Email Is this a confidential nomination?* Yes No An active NEWEA/WEF membership is required for award nominations. Contact NEWEA at 781-939-0908 for their Membership ID# if not known. The NEWEA Membership ID # is the same as the WEF ID #. The Asset Mgmt, Energy Mgmt, Keough, and Youth Educator Awards are exempt from this requirement.Candidate's NEWEA Membership ID # Basis for Award Summary (75 words or less):*Provide a description of specific reasons why the candidate is being nominated for this award (i.e. relevant association and work-related accomplishments). Additional supporting information relative to this nomination can be attached below.For the Green Steps Award Nomination, please include: - How the project exemplifies the economic, social and environmental principles of sustainability; - Why the project is innovative; - What advantages are anticipated (e.g., financial, operational, GHG reduction and/or energy efficiency); -How the project met or exceeded the client’s needsSupporting information (if desired) Drop files here or Select files Accepted file types: pdf, doc, docx, jpg, gif, png, Max. file size: 64 MB. Candidate's Biographical Info (75 words or less)*Provide a brief biographical summary of the candidate's relevant professional experience. Additional information, such as a resume, can be provided below.Supporting information (if desired) Drop files here or Select files Accepted file types: pdf, doc, docx, jpg, gif, png, Max. file size: 64 MB. Δ