Operator of the Year Nomination Form

INSTRUCTIONS: All fields must be completed for Award eligibility. Please refer to the "Operator of the Year" Awards Criteria as you complete this application. To be considered in the next Award, your completed form must be submitted by May 18th. GOOD LUCK!

Operator Description
Operator Name*
Plant/Employer*
Mailing Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Telephone*
Email Address*
Email Notifications*
- Yes, I authorize receiving publication email notifications
- No, I would not like to receive publication email notifications (opt-out)
Authorization for receiving publication email notification from NWMOA.
(applies to all email addresses on this form)
Brief Treatment Process Overview*
Personal
Years of Experience*
Years with Present Employer*
Operator's License No. and Classification*
Previous Plant Operations Experience*
Educational Contact Hours Earned During Past 24 Months*
Professional
NWMOA Membership (years)*
Years in Present Job*
Operator Deserves This Award Because*
Describe How the Operator Exhibits a Job Effort that is Above and Beyond the Normal Requirement for His or Her Position.*
Describe How the Operator Demonstrates a Working Knowledge of Membrane Process and Willingness to Further their Knowledge on a Regular Basis.*
Describe How the Operator Represents His or Her Employer in Positive Manner in the Water or Wastewater Industry.*
List Any Awards or Honors the Operator has Received.*
File
Upload any supporting documents with this application that may be helpful in evaluation your candidate for the Outstanding Operator Award.
Drop files here or

Accepted file types: jpg, png, pdf, doc, docx, xlsx, xls.
Your Contact Information
Your Name*
Title*
Telephone
Email Address*
Mailing Address*
Street Address Address Line 2 City State ZIP Code
Questions/Comments
Questions/Comments
Final Step of Nomination Process
Captcha
Please enter the letters displayed below to complete your nomination and then click Submit.

Operator of the Year Nomination Form

Operator Description

Personal

Professional

Your Contact Information

Questions/Comments

Final Step of Nomination Process

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