CTWEA Awards Nomination Form "*" indicates required fields Select Award*Select AwardOperations Leadership AwardSafety AwardLaboratory Excellence AwardOutstanding Service AwardCollection Systems Operator AwardCandidate's Name (as it should appear on the award)* First Last Candidate's TitleCandidate's Company/Affilation*Candidate's TelephoneCandidate's Email Candidate's Mailing Address* Street Address City State / Province / Region ZIP / Postal Code Nominator's InformationNominator's Name* First Last Nominator's Company/Affilation*Nominator's Telephone*Nominator's Email* Is this a confidential nomination?* Yes No Candidate's CTWEA Membership ID #Yes, They have a Membership with CTWEANo, They don't have a Membership with CTWEAMaybe, Please verify and contact me if no membership is foundAn active CTWEA membership is required for award nominations. Contact CTWEA at info.ctwea(at)gmail.com for their membership statusBasis for Award Summary*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.Add supporting information (if desired) Drop files here or Select files Max. file size: 50 MB.
