Award Application Form

 (Copy application form, complete form, and save as a Word document and send by email to Robert Newman, High Desert APWA Branch President or mail application form to: City of Santa Clarita, Attn: Robert Newman, 23920 Valencia Blvd. Ste 225, Santa Clarita, CA 91355)

(Date of Application)

Award Category applied for:

___ Outstanding Public Works Project of the Year

___ Outstanding Public Works Employee of the Year

___ Best Use of Technology

___ Best Improvement for Public Safety

___ Innovative Design of the Year

___ Best Environmental Project

Name of Employee, Project, Program, or Design: ?

Reason for Nomination (description): (maximum of one page of description and three pages of backup information)

Agency/Company: ?

Mailing Address: ?

Sponsor's Data (must be an APWA High Desert Branch member):

Name: ?

Title: ?

Phone Number: ?

Fax Number: ?

Email Address: ?