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Lincoln-Lancaster County Health Department
Environmental Public Health

Environmental Awards Nomination Form


 Environmental Awards

Deadline

This on-line form must be submitted by April 1, 2008.

Nominee Information

Nominee Name
Mailing Address
City
Zip Code
Phone
E-mail

Nominated By

Name
Mailing Address
City
Zip Code
Phone
E-mail

Award Categories

Check one of the following categories:

Eligibility

To be eligible for an award, nominees must have been instrumental in identifying, reducing, or solving an environmental problem and/or promoting public awareness and active concern for the enhancement and protection of the environment. Additionally, nominees must demonstrate one or more of the following environmental practices:


Written Summary of Achievement

Describe how the nominee's efforts and achievements fulfill the eligibility as defined above. Please include specific environmental practices and quantify results:

Description of Environmental Activity:

Degree and Length of Involvement in the Environmental Activity:

Impact on Public Health, the Environment, or Environmental Awareness:

Additional Comments:



Attach or forward any letters of endorsement, photos, charts, or other supporting materials to:

Lincoln-Lancaster County Health Department
Environmental Public Health Division
3140 N Street
Lincoln, NE 68510

Questions?

Call 402-441-4602


Environmental Awards