I, the undersigned, hereby nominate ______________________________________________________
for consideration by the Council of the Association of Professional Engineers, Geologists and Geophysicists of Alberta (APEGGA) for the Project Achievement Award.

My nomination, to the best of my knowledge, meets the criteria. The professional members involved are members in good standing with APEGGA and display good character and high ethical standards.

To the best of my knowledge, all supporting evidence attached to this nomination is correct.

Name (in full) ________________________________________________________________________

Residence Address ___________________________________________________________________

_________________________________________________Residence Phone ___________________

Business Address ____________________________________________________________________

Business Phone _______________________________ Fax __________________________________

Present Occupation/Responsibility/Title ___________________________________________________

____________________________________________________________________________________

____________________________________________________________________________________

University Degree(s) ___________________________________________________________________

Other Honours and Distinctions (APEGGA or otherwise) _____________________________________

____________________________________________________________________________________

Paper/Meritorious Work ________________________________________________________________

____________________________________________________________________________________

Name (in full) ________________________________________________________________________

Residence Address ___________________________________________________________________

_________________________________________________Residence Phone ___________________

Business Address ____________________________________________________________________

Business Phone _______________________________ Fax __________________________________

Present Occupation/Responsibility/Title ___________________________________________________

____________________________________________________________________________________

____________________________________________________________________________________

University Degree(s) ___________________________________________________________________

Other Honours and Distinctions (APEGGA or otherwise) _____________________________________

____________________________________________________________________________________

Paper/Meritorious Work ______________________________________________________________

____________________________________________________________________________________

Name (in full) ________________________________________________________________________

Residence Address ___________________________________________________________________

_________________________________________________Residence Phone ____________________

Business Address ____________________________________________________________________

Business Phone _______________________________ Fax __________________________________

Present Occupation/Responsibility/Title ___________________________________________________

____________________________________________________________________________________

____________________________________________________________________________________

University Degree(s) ___________________________________________________________________

Other Honours and Distinctions (APEGGA or otherwise) _____________________________________

____________________________________________________________________________________

Paper/Meritorious Work ________________________________________________________________

____________________________________________________________________________________

UNIQUENESS

___________________________________________________________________________________

____________________________________________________________________________________

PROJECT PROCESS

____________________________________________________________________________________

____________________________________________________________________________________

PROJECT LOCATION

____________________________________________________________________________________

The first signed nominator will be considered to be the contact person for the APEGGA Honours and Awards Committee and must sign the first sheet.

Signature ___________________________________________________________

Name _____________________________________________________________

Occupation _________________________________________________________

Address ___________________________________________________________

_________________________________________________________________

_________________________________________________________________

Business Ph _____________________ Residence Ph ______________________

Signature ___________________________________________________________

Name _____________________________________________________________

Occupation _________________________________________________________

Address ___________________________________________________________

_________________________________________________________________

_________________________________________________________________

Business Ph _______________________ Residence Ph ____________________

Signature __________________________________________________________

Name _____________________________________________________________

Occupation _________________________________________________________

Address ___________________________________________________________

_________________________________________________________________

_________________________________________________________________

Business Ph _____________________ Residence Ph ______________________