2007 Call for Nominations Leadership and Service Awards

Nomination Form George S. Wham Leadership Medal

Nomination Deadline: Monday, July 16, 2007 Please submit all nominations electronically: [email protected]

George S. Wham Leadership Medal

The George S. Wham Leadership Medal honors outstanding contributions by an individual who has provided direction and long-range planning to the ANSI standards federation in commitment and support of the national and/or international standards system or in a specific area of voluntary standardization.

The selection of a recipient for this medal will be primarily based on the individual’s support of international standards and his or her demonstration of direction and long-range planning provided to the ANSI Standards Federation in a specific area of voluntary standardization.

Note: Only one George S. Wham Leadership Medal may be awarded per year. If, in the judgment of the Awards Committee, no candidates meet the eligibility requirements, an award may not be given. The Awards Committee reserves the right to present a nominee with an award other than the one for which he or she was nominated.

Nominee

Name

Employment Please select Status Current Employee

Title*

Organization*

Address

Telephone

Fax

E-mail

*Please include current information unless nominee is retired, then include most recent employer and job title.

Nomination Deadline: Monday, July 16, 2007 Page 1 of 3 2007 Call for Nominations Leadership and Service Awards

Nomination Form George S. Wham Leadership Medal

Nomination Submitted by (Eligible Sponsor)*

Name

Title

Organization

Business address

Telephone

Fax

E-mail

*Nominations may be submitted by any member of the Institute; by members of any ANSI Board, committee council, or other group; or by the members of an ANSI-accredited standards body or certifier. Nominations submitted with the endorsement of an entire group will be considered accordingly.

Sponsor’s This nomination is being submitted on behalf of: Statement of Authority Myself, as an individual sponsor *

*If submitting on behalf of an employer or organization, please indicate that organization’s name below:

Electronic By checking the box shown at left, I confirm that I, my employer, or the Signature organization that I represent qualify as an eligible sponsor as defined above. This mark constitutes my electronic signature endorsing the nomination contained herein.

Statement of By checking the box shown at left, I confirm that I (or another person Availability designated by me) will be available to participate in the presentation of awards during a formal (black-tie optional) banquet and ceremony on Wednesday evening, October 17, 2007, in Washington, DC, should the nominee identified on this form be selected.

Nomination Deadline: Monday, July 16, 2007 Page 2 of 3 2007 Call for Nominations Leadership and Service Awards

Nomination Form George S. Wham Leadership Medal

Personal Statement from the Sponsor

Please include a short, PERSONAL STATEMENT (suitable for quotation in the nominee’s biography to the Awards Committee) explaining why you believe this candidate is deserving of the George S. Wham Leadership Medal. Please cite leadership characteristics and one or more specific accomplishments to support your statement.

Summary of Professional Background

Please provide a 100- to 200-word SUMMARY of the nominee’s professional background, promotion of international standards, demonstration of his or her direction and long-range planning provided to the ANSI federation in support of a specific area of standardization, and other relevant factors reinforcing his or her eligibility for the George S. Wham Leadership Medal.

Additional Information

Please include any additional relevant information of the nominee’s professional career (a resume or curriculum vitae may be attached).

Nomination Deadline: Monday, July 16, 2007 Page 3 of 3