Escolar Documentos
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NOMINATION FORM
1. Category [Please tick () ONE only] Reducing Greenhouse Gas Emissions/Improving Air Quality Minimizing Waste Protecting land/water resources and biodiversity Green Entrepreneur/Manager
Community action for the environment: volunteers and members of non-profit organization
2. Title
Details of Nominee
Zip Code
Mobile No Fax No
Email
MCCC GREEN AWARD 2012
Website/ Homepage Academic/ Professional Qualifications Honours and Awards (List only Professional Honours and Awards which are conferred. Do not list Membership of Professional Society which is obtained by application)
3. Title Name
Details of Nominator
Designation Organization
Address
Zip Code
Mobile No Fax No
4.
(The nominator should mention how long he/she has personally known the nominee and how well he/ she are acquainted with the activities and contribution of the nominee, professional or otherwise ;).
5.
6.
(Please use attachment if space provided is insufficient) 7 Describe what motivated your nominee to make a difference in his/her actions/ products/services/activities/ research contribution?
Describe the achievement and impact of your nominee's actions/products/services/ activities/research contribution that have had on Environmental Sustainability and Green Growth in the ASEAN region?
8.
(Please use attachment if space provided is insufficient) 9. Why do you think that this nominee should be awarded the Green Soldier Award?
Address
Zip Code
Mobile No Fax No
10. Details of Referee (Referee cannot be from the same institution as the nominee. Please provide details of a referee whom we can approach for a reference. Please ensure referees contact details are valid.)
Declaration I, the undersigned grants to the ASEAN Academy of Engineering and Technology the right to copy, reprint, quote or publish the above information as part of its awards program or other public communication. Nomination materials become the property of ASEAN Academy of Engineering and Technology and will not be returned.