Form: NARCDC-AW #2

Application for Consideration

For an Annual

NARC&DC Award

Award Name:  __________________________________________________________

Nominee:  _________________________            Submitted By:  ______________________

Region:  _____________________________            Date:  ________________________

Proposed By:  _________________________________ RC&D Council;

Address:  _______________________________________________________________

Telephone:  __________________                        E-Mail Address:  ____________________

Nominee’s RC&D accomplishments during the past year:  

Why this organization/person should be so honored, including the candidate’s strengths as related to the purpose of the award (a limit of one additional page [both sides] will be allowed):

Submitted By:  ___________________________            Signature:  __________________

Title:   _____________________________                        Date:  ______________________