2019 Annual Award Submission

There are three ways to submit your nomination:

Submit the nomination electronically by completing the form below.
Mail the 2019 SAFE Awards Form (PDF) to the SAFE Association, Post Office Box 130, Creswell, OR 97426-0130
FAX the nomination to (541) 895-3014

For in depth information regarding the 2019 Annual Award, click here to download the SAFE 2019 Awards Booklet.

Nomination for Awards - All Information is Required

Nominee Information

Nomination For:

If Team Achievement Award is chosen, please list the names and email addresses of each of the team members in the textarea below. Please include the name of the Program Manager or Team Leader, if applicable. Enter the awardee name followed by the email address on separate lines:
e.g. John Smith, john@abccompany.com

Team Information:

Nominee's Name:

Affiliation:

Mailing Address Line 1:

Mailing Address Line 2:
(if applicable)

If located in the U.S., please enter your Zip Code:

City:

State:

Country:

Province:

Foreign Postal Code:

Telephone Number:

Email Address:

Narrative:

Write and or paste Narrative describing achievements for which nomination is submitted. (box may display part of what is written but sends all)

Your Information

Nominated by: