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
- Company Commitment
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