199 National Environmental Achievement Awards
General Information Sheet
Individual Achievement
_____Public Serive Award____Federal _____State _____Local_____Distinguished Performance Award
_____President's Award
_____Environment Award
Nominee Information
Name of Nominee: | __________________________________________________________ |
Title | __________________________________________________________ |
Member Agency Achievement
_____Research Technology Award_____Operations Award
_____Public Service Award
_____Public Information & Education Award
_____Video _____Printed Publication _____Educational Program
Agency Name: | __________________________________________________________ |
Project/Program Name: | __________________________________________________________ |
Community's Chief | __________________________________________________________ |
__________________________________________________________ | |
__________________________________________________________ | |
__________________________________________________________ |
Nominee Information
Nominee Address: | __________________________________________________________ |
__________________________________________________________ | |
__________________________________________________________ | |
Nominee Phone | __________________________________________________________ |
Nominator Information
Nominee Address: | __________________________________________________________ |
Agency or Company | __________________________________________________________ |
Phone Number | __________________________________________________________ |
Return to MU97-22