Woman of Year

LOUISIANA CONFERENCE ON WATER SUPPLY, SEWERAGE, AND INDUSTRIAL WASTES, INC.

WOMAN OF THE YEAR AWARD

NOMINATION FORM

The Woman of the Year Award is awarded not more than annually to a woman with at least five (5) years of experience in the water/wastewater field and has demonstrated ability and leadership in conference activities.

The purpose of honoring conference members with this award is to recognize outstanding contributions of time and effort and to encourage and inspire other women to likewise serve the public good and the conference.

Date:

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1. Nomination submitted by:

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2. Name of Nominee:

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3. Address:

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4. Present Employer:

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5. Title of Present Position:

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6. Certification Status: Louisiana Classification:

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Field:

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7. Education and Training:

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8. Experience in Water Supply, Sewerage or Industrial Wastes Fields:

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9. Other Honors Received:

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10. Comments:

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