Award Nomination Form

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UTAH ENGINEERS COUNCIL
Engineer of the Year 2004/
Engineering Educator of the Year 2004

The following information should be provided with each nomination.  Use additional pages as needed.

Nominating Society:  __________________________________________________________________
Society Contact:  _____________________ Phone: _________________________________________
Name of Nominee:  ___________________________________________________________________
Address:  _____________________________________________________________________
Phone:        _____________

Please give a brief paragraph summarizing the nominee's accomplishments suitable for the news media.
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Highest engineering degree:______________________________________________________________
Education:____________________________________________________________________________
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Registered Professional Engineer (Give state and number):_____________________________________
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Briefly outline the engineering society offices held or services performed and/or papers presented at local, state or national levels:__________________________________________________________________
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Special Awards and/or Patents:___________________________________________________________
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Attach resumes, letters of recommendation from peers and associates, and other information about the candidate's professional and civic activities.  Please include a letter from the president or chair of the society introducing the candidate and nominating him or her for the award.

If you have any questions, please call Carl Cook at (801)374-5771 or contact him via e-mail at [email protected].  A 3" x 5" color photo of the nominee must be included with the nomination.  Photos
will be published in the UEC Journal and banquet program.  Although not required, professional quality photos are preferred.  Return names, pictures and forms to:
                                    Carl L. Cook
                                    Utah Engineers Council Awards Chairman
                                    1435 West 820 North
                                    Provo, Utah 84601

DEADLINE FOR NAMES OF NOMINEES AND PICTURES IS NOVEMBER 15, 2003.  DEADLINE FOR INFORMATION PACKET IS JANUARY 9, 2004.