Prix Pour L’ensemble des Réalisations – Formulaire De Candidature

Date limite de soumission des nominations: 1er mai

Objectif de l’attribution

Le prix pour l’ensemble des réalisations est décerné à une personne en reconnaissance de l’accomplissement extraordinaire au cours de sa vie au domaine de l’hygiène du travail.

Avant de soumettre votre candidature, veuillez utiliser cette liste de contrôle pour vous assurer que vous avez ou allez vous conformer à toutes les exigences. Les formulaires d’endossements peuvent être soumis par une personne autre que le nominateur, comme le nominateur ou quelqu’un d’autre, à une date ultérieure, tant que c’est avant la date limite.

☐ Formulaire de nomination

☐ Deux formulaires d’endossement

☐ La candidature est soumise avant la date limite – May 1 annually / Le 1er mai de chaque année.

 

Lifetime Achievement Award - Nomination

Nominee Information

Name
Name
First
Last
Nominee Information
1. Briefly describe the nominee’s significant and exemplary contributions to the field of Occupational Hygiene that have transpired over a lifetime of work locally, nationally or internationally.

2. Describe the nominee’s work related achievements.

  • Excellence and recognition of achievements within the profession, business or industry, or the education sector that has set a benchmark for occupational hygienists to strive for. (Attach relevant documentation such as awards, letters of recognitions etc)
  • Proven positive impact demonstrated through projects or initiatives to improve worker health and safety. (e.g. list examples of projects and initiatives, preference given to projects and initiatives in Canada)

3. Describe the nominee’s service to the profession.

  • Active participation in occupational hygiene associations, societies, institutes, etc. (Attach proof of membership of an organization, chair of a committee, Board of Directors)
  • Record of mentoring students and/or junior occupational hygienists and/ or safety professionals.
  • Writing, speaking, teaching and delivering significant contributions to the field, body of knowledge and/or understanding of OH. (Attach proof of publications, articles, speaker roster at conferences)
  • Challenged our way of thinking, innovation in, and/or enhanced understanding of the field of OH

4. Describe the nominee’s service to the community.

  • Active participation in voluntary organizations, community organizations, and other paid and/or unpaid work beyond the profession.

Nominator Information

Name
Name
First
Last
Address
Address
City
State/Province
Zip/Postal
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