AMTA Awards Nomination Form This Awards Nomination will be reviewed by the AMTA Awards Committee for consideration for the AMTA Awards that will be presented each year during the MTC Conference & Exposition. Please provide your nomination on or before November 15th. Nomination Submitted byPlease fill out your contact informationSalutation*Mr.Mrs.Ms.Dr.First Name*Middle InitialLast Name*Suffix (i.e.: Ph.D., P.E., Jr.)Job Title*Organization*Mailing Address*City*State/ProvinceZIP/Postal CodeCountry*Telephone*CellEmail Address* Website Communication and Data Sharing PreferenceAMTA has been diligent in Data Security and being compliant with US and other Nations regulations in sharing your contact information as well as receiving email communications from AMTA on upcoming events and other resources.Email Notifications*Opt-In: I would like to receive all email messages from AMTA including: Membership, Event Registrations, other announcements and correspondence.Opt-Out: I would not like to receive any promotional/event notice email correspondence from AMTA. However, AMTA will still email me regarding Event Registrations/Membership.Data Sharing*Opt-In: It is ok to share my contact information (name, job title, company, address, email, phone, etc.) with AMTA (or Affiliates/Assn Partner) Board, Event Sponsors, Speakers, Moderators & Attendees.Opt-Out: Do not share my address, email or phone. Outside of AMTA Administration, only my name, title and company will be shared with AMTA (or Affiliates/Assn Partner) Board, Event Sponsors, Speakers, Moderators & Attendees. Outstanding Member AwardThis award will recognize outstanding contribution to water supply improvement through desalination and/or water reuse, by an individual who is a member of AMTA. Review Criteria will include: Outstanding contribution to improving the nation’s water supply through individual effort in the desalting and/or water reuse areas. Examples include: contribution to AMTA; contribution to the exchange of information concerning the state of the art of desalination and/or water reuse; contribution to the desalination or water reuse industries. Recipient must be an AMTA member. Please provide information below on the individual being recommended and a brief background. You may submit additional backup material if desired.Outstanding Member NomineePlease list the individual/company you would like to be nominated.Outstanding Member Nominee Background InformationPlease provide a brief description of the individual/company you would like to nominate. Or upload your file and indicate that you have uploaded from this form. Upload File for Outstanding Member Nominee Drop files here or Accepted file types: doc, docx, xlsx, xls, pdf, jpg, png. Please submit files in the following format only: doc, docx, xlsx, xls, pdf, jpg, pngOr email to email@example.com Hall of Fame AwardThis award will recognize pioneering and/or lifetime contribution by an individual to water supply improvement and/or reuse technologies utilizing membrane technologies. Review Criteria will include: Pioneering efforts in research or application to establish water supply improvement and/or reuse membrane technologies; and/or a lifetime of significant contribution in these areas. An individual inducted into the AMTA's Hall of Fame may be a member or nonmember. Hall of Fame Award recipients are granted lifetime honorary membership. Please provide information below on the individual being recommended and a brief background. You may submit additional backup material if desired.Hall of Fame NomineePlease list the individual you would like to be nominated.Hall of Fame Nominee Background InformationPlease provide a brief description of the individual you would like to nominate. Or upload your file and indicate that you have uploaded from this form. Upload File for Hall of Fame Nominee Drop files here or Accepted file types: doc, docx, xlsx, xls, pdf, jpg, png. Please submit files in the following format only: doc, docx, xlsx, xls, pdf, jpg, pngOr email to firstname.lastname@example.org Comments & CaptchaQuestions/CommentsCAPTCHAPlease enter the letters displayed above to complete your application and then click Submit.