Safety Summit Award Nomination Form

AWARD PROGRAM INFORMATION
The Zero Fatalities Award Program recognizes individuals and organizations who have made contributions to transportation safety in the State of Utah. The program recognizes accomplishments in the public and private sector by individuals, state and local governments, federal agencies and businesses and organizations that promote traffic safety. This program is sponsored by the Utah Department of Transportation (UDOT), the Utah Department of Public Safety (UDPS), and many other traffic safety partners that are dedicated to reducing death and injury on Utah's roadways. Nominations should include:

1. Description of the program(s) and/or activities that the nominee has conducted, why they occurred and what made them unique.

2. Supporting information or data on what problems existed and what the desired accomplishments were.

3. Description of outstanding elements or accomplishments of the nominee or programs (e.g. number of people trained, number of people impacted, etc.).


ELIGIBILITY
Any individual, organization, business or government agency is eligible. The nominee must have made an outstanding effort to change the attitudes and behaviors of motorists leading to the reduction of crashes, injuries and fatalities associated with transportation in Utah.


CRITERIA FOR SELECTION
There are eight award categories for which nominations will be accepted. Award selection will be made by the Zero Fatalities Safety Summit Planning Committee. Entries will be judged on impact on the community, program effectiveness, creativity, innovation and overall dedication to the field of transportation safety. An additional award category, Outstanding Traffic Safety Program Award, recognizes one UDPS and one UDOT project or subgrantee, and is selected by department leadership.


NOTIFICATION & PRESENTATION OF AWARD
Winners will be notified by March 21, 2016 and will be honored at the Zero Fatalities Safety Summit Awards Ceremony on Wednesday, April 13, 2016 at the Utah Valley Convention Center in Provo, Utah. Award recipients will be able to attend the summit at no charge and will be provided with lodging and other travel expenses, if necessary. In addition, recipients will be able to bring up to four additional guests to the awards luncheon.


SUBMIT
Completing this form online will submit your nomination. If you have any questions or concerns please contact Carrie Silcox, Utah Highway Safety Office, at 801.386.1888.


NOTE
Activities and programs must have taken place during calendar years 2014-2016. This requirement applies to all award categories except the Zero Fatalities Leadership Award, which honors an individual for sustained outstanding leadership. For nominations in this category, please include all relevant information that demonstrates a long-term effort to make Utah's roadways safer.

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