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Environmental Public Health

Environmental Awards Nomination Form


 Environmental Awards

Deadline

This on-line form must be submitted by April 2, 2012.

Nominee Information

Nominee Name (*)
Mailing Address (*)
City (*)
Zip Code (*)
Phone (*)
E-mail

Nominated By

Name (*)
Mailing Address (*)
City (*)
Zip Code (*)
Phone (*)
E-mail

Award Categories (*)

Check one of the following categories:

Eligibility

To be eligible for an award, nominees must have been instrumental in identifying, reducing, or solving an environmental problem and/or promoting public awareness and active concern for the enhancement and protection of the environment. Additionally, nominees must demonstrate one or more of the following environmental practices:


Written Summary of Achievement

Describe how the nominee's efforts and achievements fulfill the eligibility as defined above. Please include specific environmental practices and quantify results:

Description of Environmental Activity: (*)

Degree and Length of Involvement in the Environmental Activity: (*)

Impact on Public Health, the Environment, or Environmental Awareness: (*)

Additional Comments:

(*) - Required fields
When you click "Submit This Form", the next page will confirm your submission.



Attach or forward any letters of endorsement, photos, charts, or other supporting materials to:

Lincoln-Lancaster County Health Department
Environmental Public Health Division
3140 N Street
Lincoln, NE 68510
RRief@lincoln.ne.gov

Questions?

Call 402-441-4602 or email to: RRief@lincoln.ne.gov


Environmental Awards