Arnold W. Siegel International Transportation Safety Award

Nomination Form

* denotes required fields.

Nominee

SAE Member Number
(if applicable)
*Nominee's last name
*First name
Middle name
*Is the following address: Home
Business
*Title/Position
Employer
Department/Division
Mail Stop
*Street Address
*City
*State/Province
*Zip+4/Postal Code
Country
*Phone
Fax
*Email
Name of College or University
Undergraduate
Major
Degree
Graduation Date
Name of College or University
Graduate
(if applicable)
Major
Degree
Graduation Date
Name of College or University
PhD
(if applicable)
Major
Degree
Graduation Date

NOTE: The boxes below are expandable and will accomodate an indefinite amount of text. It is suggested that you type your text elsewhere and copy and paste the information electronically into the boxes.

*Basis for Nomination
Below include details on which this nomination is based. Comments should specifically highlight the nominee's leadership activities that led to unique and outstanding contributions to international transportation safety. The nomination will be judged primarily from the information provided in this section. Please be thorough when highlighting the nominee's contributions to international transportation safety. Nominations with insufficient information will not be reviewed.

*Nominee's Professional Background
Below include a biographical description of the nominee's professional background, including but not limited to, past work experience, society membership, honors or awards, etc.

Publications
Below include a listing of the nominee's publications that relate to this nomination.

SAE Contribution (if applicable)
Below include a brief description of any contributions the nominee has made to SAE activities or programs.

Supporting Recommendation
Below include at least one additional testimonial from someone other than the nominator. Along with this testimonial, include the person's name, telephone number, and email address.

Nominator

SAE Member Number
(if applicable)
*Nominator's last name
*First name
Middle name
*Is the following address: Home
Business
Title/Position
Employer
Department/Division
Mail Stop
*Street Address
*City
*State/Province
*Zip+4/Postal Code
Country
*Phone
Fax
*Email
Date of Nomination
Submit
Nomination Deadline: June 1

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