2015
NOMINATION FORM I wish to make a nomination for the 2015 Gas Industry Awards for the category indicated below (please place a tick in the appropriate box and use a separate form for each nomination) Manager of the Year
Gas Industry Leadership
Gas Industry Innovation Award
Company of the Year
Gas Industry Safety Award
Energy Efficiency
Engineer of the Year
Young Person’s Achievement
Customer Service Award
INDIVIDUAL OR COMPANY BEING NOMINATED Name______________________________________________________________ Dr/Mr/Mrs/Ms/Other ______________________ Title, Decorations _____________________________________ Qualifications ___________________________________________ Company and Address _________________________________________________________________________________________ _______________________________________________________________________________ Post Code___________________ Telephone _______________________ Fax ____________________________ Email _____________________________________
REASONS FOR NOMINATION – Up to thirty words to form the basis of the citation ____________________________________________________________________________________________________________ ____________________________________________________________________________________________________________ ____________________________________________________________________________________________________________
FOUR BULLET POINTS DETAILING ACHIEVEMENTS OR OTHER CRITERIA FOR ASSESSMENT A __________________________________________________________________________________________________________ B __________________________________________________________________________________________________________ C __________________________________________________________________________________________________________ D __________________________________________________________________________________________________________
Other supporting information to assist the Judges to reach a decision ____________________________________________________________________________________________________________ ____________________________________________________________________________________________________________ ___________________________________________________________________________
(please continue on a separate sheet, if necessary)
NOMINATOR: Name _____________________________________________________ Title ____________________________________________ Address _____________________________________________________________________________________________________ Postcode ________________ Telephone* _______________________ Email* __________________________________________ Context in which Nominee is known _____________________________________________________________________________
Signature ________________________________________________________ Date _______________ * This information will be used to contact nominators so please provide direct contact information Please send completed forms to: Gas Industry Awards 2015, Institution of Gas Engineers and Managers, IGEM House, High Street, Kegworth, Derbyshire, DE74 2DA marked “Awards Nomination - Confidential” E-mail address: gasawards@igem.org.uk CLOSING DATE FOR NOMINATIONS TO BE RECEIVED: Friday 27th February 2015 A copy of the Award Scheme Rules and Notes for Guidance is available on the IGEM Website: www.igem.org.uk or on request by e-mail to gasawards@igem.org.uk Tel: 0844 375 4436 Institution of Gas Engineers and Managers, IGEM House, High Street Kegworth, DE74 2DA Registered Charity No 214011
2015 NOMINATIONS
NOW OPEN Download your nomination form at www.gasindustryawards.com Closing date for entries 27 Feb 2015
2015 CATEGORIES Organised by:
2 colour Pantone 021 Pantone 653
Manager of the Year
Innovation
Engineer of the Year
Energy Efficiency
Leadership Award
Company of the Year
Safety Award
Customer Service
Young Person’s Achievement