WANO Nuclear Excellence Award Nomination Form 2013 - DOC by 09FjkH

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									                         WANO Nuclear Excellence Award
                                   Nomination Form
                                  (Confidential Information)

This form provides information for use by the WANO Nuclear Excellence Award selection committee. It
form must be complete and typewritten in 10 point or larger font. To ensure candidates are considered for
the award to be presented at the BGM in Moscow, Russia on 19-21 May 2013, the WANO secretary must
receive the nomination form by 7 January 2013.

Any individual whose work contributes to or supports the successful
operation of nuclear power plants operated by a WANO member(s) is eligible
for the award. (Except for regional governors, WANO officers are ineligible).
This could include contributions to any part of the infrastructure that
supports the nuclear power enterprise. It could also include contributions
through WANO.

1.      Candidate Name (first name, middle initial, last name):




2.      Candidate’s Primary Employer (include address and telephone number):




3.      Education, professional licences, special training completed, etc.




4.      Specific Accomplishments and Contributions Meriting Receipt of the
     WANO Nuclear Excellence Award (Accomplishments and contributions may
     be direct or indirect but must clearly support achievement of excellence in
     operation of nuclear power plants. Definitive and quantifiable results of the
     candidate’s efforts should be included):
5.      Proposed Citation (Suggest the text to be used to recognize the
     achievements and contributions of your candidate. It should not exceed 40
     words):




6.      I have obtained personally from each individual listed as a reference an
     indication of their willingness to provide a completed reference form in support
     of my nominee. (I have provided a copy of this completed nomination form and
     a blank copy of the reference form to each reference listed below)

      Nominated By:                    References:
      _______________________          1.________________________________
      Typed Name                          Name                    Telephone No
      _______________________          2.________________________________
      Signature                           Name                    Telephone No
      _______________________          3.________________________________
      Telephone No.                       Name                    Telephone No
      _______________________          4.________________________________
      Date                                Name                    Telephone No

7.      Submit this completed form to:*

             WANO Secretary
             World Association of Nuclear Operators
             Cavendish Court
             11-15 Wigmore Street
             London
             W1U 1PF
             United Kingdom

             haley@wanocc.org

     *Fax and email are acceptable methods of submitting nominations and
     reference forms. However, post is the preferred method to provide more
     confidential communication.

     Please note this postal address will change in Q3 of 2012. Please keep checking
     the WANO public and member websites for the most up to date address and
     telephone number information.
                         WANO Nuclear Excellence Award
                                     Reference Form
                                   (Confidential Information)

This form provides information for use by the WANO Nuclear Excellence Award selection committee. The
information you provide will be held confidential. Only the selection committee and the WANO secretary
will view the information. The nominator will not be informed of the views you express. It is preferred that
the information provided be typewritten; however, printing in black ink is acceptable. To ensure candidates
are considered for the award to be presented at the BGM in Moscow, Russia on 19-21 May 2013, the
WANO secretary must receive this form by 18 January 2013.

Candidate’s Name: __________________________

Nominator’s Name: __________________________

Your Name: ________________________________

1. Prior to completing this reference form, you should read and review the
   candidate’s nomination form sent to you by the nominator.

2.       I am providing information based on (tick all that apply):

               Personal knowledge of the candidate’s accomplishments and
         contributions cited by the nominator.
               Knowledge obtained through oversight of the candidates work or
         review of publication, materials, technical documents, and other products
         developed by the candidate.
               Indirect knowledge of the candidate’s work obtained from
         information provided by others.

3.       Please provide comments on the specific accomplishments and
     contributions meriting receipt of the WANO Nuclear Excellence Award as
     submitted in section 4 of the nomination form. (Comments should be specific to
     the information in section 4, providing quantifiable results where possible.
     Additional accomplishments and contributions should normally be avoided
     unless they are closely related to or supportive of the information submitted on
     the nomination form).
4.      Compared to other potential recipients of the award, I would rate this
     candidate as:

                Especially deserving
                Highly deserving
                Deserving
                Less deserving than others

8.       Submit this completed form to:*

             WANO Secretary
             World Association of Nuclear Operators
             Cavendish Court
             11-15 Wigmore Street
             London
             W1U 1PF
             United Kingdom

             haley@wanocc.org

     *Fax and email are acceptable methods of submitting nominations and
     reference forms. However, post is the preferred method to provide more
     confidential communication.

     Please note this postal address will change in Q3 of 2012. Please keep checking
     the WANO public and member websites for the most up to date address and
     telephone number information.

     Please notify the nominator when this form has been mailed. Because you are
     providing an independent view, please DO NOT provide a copy of your
     completed reference form to the nominator.


         ________________________             _____________________
         Signature                               Date

         ________________________             _____________________
         Telephone number                        Email address

								
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