2009 Clean Air Campaign Awards Official Nomination Form

Please complete all pages of the nomination form. NOTE: Only projects and programs that have been implemented between August 1, 2008 and July 31, 2009 are eligible. (One entry per form.) Entry deadline: Friday, August 28, 2009, 5:00 p.m.

SUBMITTING INSTRUCTIONS: If sending large sample materials with your entry(ies), please save and print this entry form and mail with supporting documents to:

Valley Metro Clean Air Campaign Awards 302 North 1st Avenue, Suite 700 Phoenix, Arizona 85003

If submitting small files or supporting documents, please email this entry form and supporting documents to: [email protected].

FOR MORE INFORMATION: Call 602.534.6472 or contact your Business Services Representative. Or, email questions to: [email protected].

Information

Nominee (Individual or Organization)

Title

Company or Organization Number of Employees

Address

City State Zip

Phone E-mail

Nominator (Person submitting award)

Phone E-mail

Company Single Occupancy Vehicle (SOV) rate (from Trip Reduction Survey results):

Most recent year measured: Previous year measured:

Date

If the entry wins, how should the award be imprinted? (Only one individual name or organization can be listed.)

Name of person accepting award at luncheon

Title of person accepting award

Phone E-mail

Page 1 of 3 Description of the Program

Provide a maximum 250-word description of the program, project or person you are nominating. In addition, explain why you believe this entry should win (include any statistics you feel may assist the judges).

Page 2 of 3 Category (Select one per entry)

Outstanding Transportation Coordinator

50-149 employees

150-499 employees

Over 500 employees – Public Employer

Over 500 employee – Private Employer

Outstanding Trip Reduction Program

50-149 employees

150-499 employees

Over 500 employees – Public Employer

Over 500 employee – Private Employer

Outstanding Marketing and Creativity

Electronic and/or Print Media

Marketing Event or Campaign – Under $500 Budget

Marketing Event or Campaign – Over $500 Budget

Bulletin Board

Outstanding Bike Program

Public Employer

Private Employer

Outstanding Commuter

Outstanding Transit Rider (Bus or Light Rail)

Outstanding Carpooler

Outstanding Vanpooler

Outstanding Bicyclist or Walker

Outstanding Multi-modal Commuter

Outstanding Leadership

Outstanding Telework Program

Page 3 of 3 Best Telework Advancement