Operator of the Year Nomination Form

INSTRUCTIONS: All fields must be completed for Award eligibility. Please refer to the Operator of the Year" Awards Criteria as you complete this application. To be considered in the next Award, your completed form must be submitted by extended deadline July 17, 2018. GOOD LUCK!

Operator Description
Operator Name*
Plant/Employer*
State PWS ID#*
TCEQ Plant ID#*
Mailing Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Telephone*
Email Address*
Brief Treatment Process Overview*
Personal
Years of Experience*
Years with Present Employer*
Operator's License No. and Classification*
Previous Plant Operations Experience*
Please Provide the Number of Education Contact Hours and List Courses Attended During the Past 24 Months:*
Professional
SCMA Membership (years)*
Years in Present Job*
Operator Deserves This Award Because*
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Describe How the Operator Exhibits a Job Effort that is Above and Beyond the Normal Requirement for His or Her Position.*
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Describe How the Operator Demonstrates a Working Knowledge of Membrane Process and Willingness to Further their Knowledge on a Regular Basis.*
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Describe How the Operator Represents His or Her Employer in Positive Manner in the Water or Wastewater Industry.*
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List Any Awards or Honors the Operator has Received.*
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Your Contact Information
Your Name*
Title*
Telephone
Email Address*
Mailing Address*
Street Address Address Line 2 City State ZIP Code
Communication and Data Sharing Preference
SCMA has been diligent in Data Security and being compliant with US and other Nations regulations.
Email Notifications*
Authorization for receiving publication email notification from SCMA.
(applies to all email addresses on this form)
- Yes, I authorize receiving publication email notifications
- No, I would not like to receive publication email notifications (opt-out)
Data Sharing*
- Opt-In: It is ok to share my contact information (name, job title, company, address, email, phone, etc.) with SCMA Board, Event Sponsors, Speakers, Moderators & Attendees.
- Opt-Out: Do not share my contact information. Outside of SCMA Administration, only my name, title and company will be shared with SCMA Board, Event Sponsors, Speakers, Moderators & Attendees.
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Operator Description

Personal

Professional

Your Contact Information

Communication and Data Sharing Preference