2017 – 2018PROFESSIONAL OF THE YEAR

IRWA Puget Sound Chapter 4

NOMINATION FORM

Here’s your opportunity to recognize that special someonewho has made significant contributions to the Right of Way profession this year? Contributions can come in various aspects such as chapter officers and committees served, chapter function attendance, professional coursework completed, recognition by other professional organizations, IRWA Professional Designationsachieved, etc.

The knowledge that your efforts are appreciated by colleagues is invaluable! It can motivate a right-of-way professional to meet the toughest challenge. Who do you feel deserves to be recognized for their contributions this past year?

Please complete the general information below, including SectionsI through V, to best describe your nominee’s commitment and contribution to the Right of Way profession through the period of July 1, 2017 through April 30, 2018.

This Special Award will be presented during theJune 2018 – Officer Installation Dinner.

Name of Nominee:______

Employer:______

Title:______

Address:______

(Street)

______

(City, State, Zip)

Business Phone:______

Email Address:______

Years as an IRWA Member: ______SR/WA Number: ______

SR/WA Candidate Number: ______

______

Signature – Nominee’s Review and Concurrence of Data SubmittedDate

______

Signature – Individual of Nominating MemberDate

Section I – Offices & Committees Served
Chapter Offices (Position & Duties)
Chapter Committees (Position & Duties)
Section II – Chapter Support
Assignments or Projects (Duration & Tasks Performed)
Chapter Meeting Attendance Record (Total of 9 chapter general membership meetings)
New Members Sponsored (Provide names of those sponsored)
Section III – Educational Courses and Activities
IRWA Courses Completed (Course Name, Number, Date Completed)
IRWA Course Coordinated or Instructed (Course Name, Number, Date Completed)
Section IV – Contributions to the Right of Way Profession
Special Recognition from Employer
Special ROW Related Projects Outside IRWA
Other Membership & Participation
Section V – IRWA Professional Designation
Senior Member of IRWA (SR/WA Designation) / Date of Designation
SR/WA Recertification / Date of Recertification
SR/WA Candidate / Date of Candidacy
Section VI – Additional Information
Please use the space below to list and or describe any additional related information to further acknowledge and explain why your nominee should be Chapter 4 Professional of the Year.

______

Printed Name of Nominating MemberTelephone Number

______

Email address

Please send your completed nomination form via US Mail or by Email to:

Janice Warren, PMP, SR/WA

Chair: Nomination, Elections and Special Awards

123 2nd Avenue S, Suite 200

Edmonds, WA 98020

Email:

Phone: 425-218-2059

All nomination forms must be received by:
APRIL 30, 2018
(To be presented at JUNE 2018 Chapter 4 GENERAL MEMBERSHIP MEETING)

PLEASE DO NOT USE THIS SECTION – FOR COMMITTEE USE

Date Received:______

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