Mark Hidalgo Mentor of the Year Award

Please fill out the form below. You will be sent an email with further instruction regarding the application process and how to submit your supporting application information.

You will be asked for the following:
A list of sites mentored from January 1st to December 31st of the previous calendar year.
Your complete contact information.
Three letters of recommendation – one from a site you mentored, a supervisor of yours, and a co-worker.
A picture of you or the person you are nominating.

You will also be asked for a brief description on how you meet the below criteria:

Scope of activities such as – Number of assisted VPP onsite evaluations, number of potential VPP sites mentored, number of OSHA training co-instructed (i.e. SGE course, OSHA Ed Center courses).
Technical Expertise
Initiative
Dependability
Company Commitment

Notice

The winners will be recognized at the Regional conference and at the National Conference. The photo that you supply will potentially be placed in any conference publications

Name(Required)

First Last

Company(Required)

Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Email(Required)

Phone(Required)

Please fill out the information for the person being nominated. If you are nominating yourself, please duplicate your information below.

Nominee(Required)

First Last

Nominee Company(Required)

Nominee Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Nominee Email(Required)

Nominee Phone(Required)

Mark Hidalgo Mentor of the Year Award

Notice

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