Candidate Application Form
Congratulations on your nomination as a Rochester Engineering Society Rochester Engineer of Distinction.
Before completing this Candidate Application Form, ensure you have read the General Information and Entry Guidelines document. You can obtain this from the RES office or at the RES website:
Deadline for Nominations
Initial Nominations MUST be received by Monday,December 11, 2017
Final Nominations MUST be received by Monday,January 8, 2018
Please email or mail your nomination to our office at
657 East Ave., Rochester, NY 14607.
Email to
Award Presentation
The 2017Rochester Engineer of Distinction Awardswill be presented at
the RES Annual Gala onSaturday, April 14, 2018at the
Rochester Riverside Convention Center.
Instructions for Completing and Submitting Entry Forms
- Read the "Award Criteria and Procedures" section of the General Information document and review the application form carefully before beginning entries.
- Be sure to fill in the entry form completely, including signatures, pertinent dates, and all other data. Incomplete forms cannot be properly judged.
- Please type or word process all information. Handwriting is too difficult to read. Make sure the candidate’s name appears on all pages.
- Submit the final application form to the RES offices by January 8, 2018. You can email an electronic version or mail an original copy to
657 East Avenue, Rochester, NY 14607.
If you have questions, please call the RES office at 585-254-2350 or email . You can also access this information on the RES website
Please do not simply attach a Resume or Biography. To objectively evaluate each candidate, the Selection Committee requires that the supporting documentation be in the same format for each nomination.
General Information
Candidate / NominatorName
Mailing Address
Business Phone
Indicate which Criteria in item 1 of the General Award Information document qualifies this candidate:
Check all criteria which apply:
A ☐ ABET-accredited graduate
B ☐ Graduate with at least four years professional experience in engineering work
C ☐ NYS registered Professional Engineer
D ☐ Equivalent professional competence evidenced by unusual personal development and
professional accomplishments
Number of years practicing engineering: ______
Licenses and Certifications:
______
Candidate’s SignatureNominator’s Signature
______(date)______(date)
ENGINEERING ACHIEVEMENTS for ______
EODCandidate’s Name
Current Position:
Title and company or institution
Level of Responsibility:
Use this space to describe what you do. Include any supervisory, management, or budget responsibilities.
Accountability:
In narrative form, explain any particular challenges encountered and overcome or skills required. Draw for all areas of your career, not just your current role.
(Continued)
ENGINEERING ACHIEVEMENTS for ______
EODCandidate’s Name
Awards:
List any recognitions that support your achievements.
Patents awarded or applied for:
PROFESSIONAL EXPERIENCE AND BUSINESS ACUMEN for ______
EODCandidate’s Name
Provide dates and organizations where you were employed and give a brief description of what your duties involved. This will help the committee understand what your involvement and level of responsibility have been. We are also evaluating if the candidate demonstrates leadership and sound decision making skills.
Please do not simply attach a resume. We are looking for more of a narrative that describes your roles and accomplishments.
CONTINUING COMPETENCE for ______
EODCandidate’s Name
Describe what you have done to stay current in your field.
Include any continuing education and training. Provide course names, dates, and why it is relevant.
Consider any papers you published or presentations you delivered.
(List a maximum of 10 relevant articles, journals, conferences, dates)
PROFESSIONAL SOCIETY ACTIVITIES for ______
EODCandidate’s Name
Activity and Leadership in Professional Societies
Include all local, state and national affiliations. Please specify offices held, and committee duties. Provide dates and responsibilities.
CONTRIBUTIONS IN CIVIC, COMMUNITY and HUMANITARIAN ACTIVITIES for
______
EODCandidate’s Name
Describe how you are involved in, and contribute to, making Rochester a better place to live.
Provide data such as name of organization, date joined, committee assignments, and offices held. Be specific and describe what activities you were involved in and what roles you preformed.
Attach supplementary information, as necessary.
COLLEGE EDUCATION AND SCHOLASTIC ACHIEVEMENT for
______
EODCandidate’s Name
Please list all degrees you hold and when and where they were earned. Include honorary societies, awards, and organizations you were involved in. Consider extra activities in which you participated.
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