Region III Safety Professional of the Year Nomination Form

The ASSP Regional SPY award is an honor acknowledging the dedication and outstanding contributions of a member to a specific Region. To be eligible nominees must:

  1. Be a Professional Member or Member in good standing of their Region, Chapter and the Society.
  2. Not have received this award within the past five (5) years.
  3. Be engaged in full-time employment in the profession of protecting people, property and the environment.

Nominees are not eligible if they are currently serving as a member of the Board of Directors or the Regional Awards Committee, or have been elected an ASSP fellow.

JUDGING CRITERIA

Only the nominee’s past three (3) years of activities will be considered.

  1. Demonstrated technical expertise in the broad field of safety and a thorough knowledge of the operational aspects of his/her safety employment.
  2. Demonstrated outstanding contributions to the Society, Council, Chapter, Region or Practice Specialty activities, including committee or task force chair, officer, services to members, lecturer at seminars, etc.
  3. Professional contributions to advance the Safety Profession, such as fostering professional development, public/community services, instructor at educational institutions, involvement in codes and legislation, articles written, work with allied groups, etc.
  4. Awards and innovations, including citations, honors, plaques; or new procedures or systems developed.
  5. Leadership in establishment, maintenance, and improvement of technical or Society programs in the organization nominee serves or elsewhere.
  6. Other personal achievements related to safety and health.
  7. Endorsements by superiors and verifications by associates, in the form of letters on appropriate stationery of the employer and Chapter, Council, or Practice Specialty.

    Nominee Information

    Nominee's Name (required)

    Nominee's Title (required)

    Nominee's Company (required)

    Nominee's Address (required)

    Nominee's City (required)

    Nominee's State (required)

    Nominee's Zip (required)

    Nominee's Phone (required)

    Nominee's Email (required)

    Briefly Describe Nominee's Current or Recent ASSP Activities (required)

    Nominee's One to Three Page Resume (pdf, doc, docx) (required)

    Nominee's Photo (jpg, jpeg, png, gif) (required)

    Nominator's Information

    Nominator's Name (required)

    Nominator's Title (required)

    Nominator's Address (required)

    Nominator's City (required)

    Nominator's State (required)

    Nominator's Zip (required)

    Nominator's Phone (required)

    Nominator's Email (required)

    Nominator's Letter of Endorsement (pdf, doc, docx) (required)

    Supervisor's Letter of Endorsement (pdf, doc, docx) (required)