2019 QCESC Award Nominations
The Quad City Engineering and Science Council (QCESC) originally established its awards program in 1966. The purpose of the awards is to pay tribute and recognize engineering, science, and technical professionals and educators whose exceptional achievements and outstanding contributions have made a lasting impact on technology, society, and their profession. This includes helping to promote and raise the awareness of engineering and science in our local communities.

General Information:

1. Any technical society, business, organization, or individual may submit as many nominations as they wish. Multiple nominations of the same person will not enhance the changes of winning the award.

2. Please note that If a nominee previously won the award being applied for during the prior 3 years, that nominee will be excluded from consideration for that award. Except for the Lifetime Achievement Award, a nominee may be awarded more than once in his/her lifetime.

3. It is preferred that candidates do not self-nominate. QCESC is looking for candidates to be nominated and recognized by others.

4. It is very important that the nomination be completely filled out with the information requested in each of the fields. The Award Selection Committee assigns points for each nominee for each of the fields based on the information submitted. Required fields are marked with * Required. If you don't have any information for the field, input "none".

5. Please avoid the use of acronyms or provide an explanation of each one used.

6. If at all possible, please submit your nominations using this Google Form. Note that some company computer systems block access to GoogleDrive and GoogleForms. If so, please try submitting using your home internet or a public internet service. However, if all else fails you can email a Word file with the information requested. Below is a link to an example Word Document nomination to serve as a guide. You can send this completed Word Document to dandales99@gmail.com before the deadline. Copy the following link to your browser to retrieve the Word document:

https://drive.google.com/open?id=1nNbxjZqTL9ngNZl9rV0JqbrHqrNmKqpP

7. In addition to the award nomination, please e-mail a color or black and white digital photo (head shot) to dandales99@gmail.com for potential use with the press release and for posting to the QCESC website.

8. Nominations for any award will be automatically resubmitted for two additional years if not selected in the initial year of submission. The nominator may be asked to update the resubmission as needed.

9. The awards will be announced at the 57th Annual National Engineers Week Banquet scheduled for Thursday, February 21, 2019.

10. All award applications must be submitted by Monday, February 4th, 2019.

11. If you have questions or need further Information, contact: Dan D'Alessandro, President and Awards Chair, at dandales99@gmail.com.
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The Email address requested below is for the person submitting the nomination. They will receive a copy of the award nomination after submitting.

Email address *
Award Category (select one): *
Award Nominee Information:
Name (example John Smith): *
Your answer
Employer: *
Your answer
Job Title: *
Your answer
E-mail Address: *
Your answer
Cell Phone or Business Phone: *
Your answer
Business Address (example 1000 1st Street, Moline, Illinois 61265): *
Your answer
Home Address: *
Your answer
Birth Date (needed for Engineer & Scientist Awards) *
Your answer
Nominees information by category for evaluation for the award
Please provide concise information with specific accomplishments with the nominees contributions clearly explained.
Citation (50 word maximum) that summarizes the nominee’s qualifications and merit for the award. This should be in third person and will be used with the press release: *
Your answer
Education (Includes degrees, dates, schools, and majors) *
Your answer
Work Experience (includes dates, titles, companies/universities and synopsis of responsibilities. Key focus of information should be accomplishments/results/impacts instead of time periods positions were held) *
Your answer
Professional affiliations and activities (include years of membership, offices/chair positions and dates): *
Your answer
Certifications and Licenses: *
Your answer
Community Activities (includes items related to promoting engineering/science) *
Your answer
Patents, Publications, or Teaching Accomplishments (For Scientist Award nominees, provide a summary of main research accomplishments, for STEM Award Nominees, provide info on STEM related teaching accomplishments.) *
Your answer
Previous Awards: *
Your answer
Nominators Contact Information:
Name (example John Smith): *
Your answer
Employer: *
Your answer
Job Title: *
Your answer
Cell or Business Phone: *
Your answer
Relationship to Nominee: *
Your answer
Business Address (example 1000 1st Street, Moline, Illinois 61265): *
Your answer
A copy of your responses will be emailed to the address you provided.
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