2018DALLAS ENGINEER OF THE YEAR AWARD

Presented by the

DALLAS CHAPTER - TEXAS SOCIETY OF PROFESSIONAL ENGINEERS

This award recognizes an established engineer who has made outstanding contributions to the engineering profession, the public welfare, and/or humankind.

NOMINATION FORM

Name of Nominee: ______Title: ______

Company Name: ______

Company Address: ______

Company Phone No. : ______FAX No. ______E-Mail: ______

Home Address: ______Phone No.:______

Eligibility: Must be NSPE/TSPE member in good standing.

Nominator: ______Phone No. (w)______E-mail:______

The TSPE Awards Committee makes the selection of the recipient based on the following Evaluation Criteria:

A.Education5%

Include undergraduate and advanced degrees (give date, major, institution and its location for each)

B.Licenses (P.E. Licensed in the State of Texas mandatory) 5%

List other licenses

C.Professional and Technical Society Activities 35%

List offices held, year held, committee assignments, awards at each level, and other professional

and technical activities (indicate time spent on furthering the engineering profession)

D. Engineering and Career Achievements35%

Include current position (title, company, or institution), responsibilities (number of subordinates,

annual budget), accountability (position, function, nature of challenge), and significant engineering

achievements. Include technical and non-technical publications, papers and patents.

E.Civic, Humanitarian & Social Activities 20%

Include service to the community and for the benefit of the humankind. List offices held, year held,

committee assignments, and awards received. Also list support of unusual or interesting activities,

such as the arts, sports, etc.

Total 100%

Nomination Format and Submission Procedure:

Nominations must be made using this form. The form should be typed, and all supporting biographical information should be provided and coded by the section number and title it supports, as outlined in the form. The information should appear on a separate page for each lettered section. The nomination form should be submitted electronically. Upon selection, the Award Recipient must submit a digital headshot (head and shoulders) with a minimum resolution of 300 dpi. The Award Recipient should plan to participate in a photo shoot funded by TSPE for the headshot.

Deadline: Nominations are due at the email address below by Friday, December 15th, 2017.

BrianJ. LaFoy, P.E., ENV SP- TSPE EOY/YEOY 2018 Awards Chair


CANDIDATE

Name:______Birth Date:______

Address:______

______

NSPE Affiliation: Chapter: ______State: ______

NSPE Member Number: ______

  1. EDUCATION

College / UniversityLocation DegreeDate

______
______
______

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  1. LICENSES

State Date NumberBranch

______

______

______

______

C.PROFESSIONAL AND TECHNICAL SOCIETY ACTIVITIES

(Indicate offices held, year held, committee assignments, and awards received.)

1. PROFESSIONAL

a. TSPE______Chapter

______Date:______

______Date:______

______Date:______

______Date:______

______Date:______

b. TSPE--State Level

______Date:______

______Date:______

______Date:______

______Date:______

c. NSPE-- National Level

______Date:______

______Date:______

______Date:______

d. Other Professional Activity (Indicate time spent on furthering the engineering

profession.)

______Date:______

______Date:______

______Date:______

2. TECHNICAL

Technical Societies (ASCE, ASME, IEEE, etc.)

a. Organization______

______Date:______

______Date:______

______Date:______

b. Organization______

______Date:______

______Date:______

______Date:______

c. Organization______

______Date:______

______Date:______

______Date:______

d. Organization______

______Date:______

______Date:______

______Date:______

e. Organization______

______Date:______

______Date:______

______Date:______

D.ENGINEERING AND CAREER ACHIEVEMENTS

  1. Position ______

Present Employer and Address

______

______
______

______

Years with the company ______

Description of responsibilities

______

______
______

______

______

______

Previous Employers

CompanyPositionDates Employed

______

______
______

______

______

______

2. Significant Engineering Achievements

List significant engineering achievements, giving description of the achievement, the significance, your responsibility, and the time period. (Additional copies of this page may be submitted if needed.)

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3. Publications, Papers, and Patents

List publications, papers, and patents giving the title, authors, publications, and/or

audience, and time period. (Additional copies of this page may be added if needed.)

______

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E.CIVIC, HUMANITARIAN, AND SOCIAL ACTIVITIES

Indicate offices held, year held, committee assignments, and awards received.

(Additional copies of this page may be added if needed.)

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