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 by the extended deadline of Nov. 15, 2017. 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*CellFaxEmail Address* Email Notifications*Yes, I authorize receiving publication email notificationsNo, I would not like to receive publication email notifications (opt-out)Authorization for receiving publication email notification from AMTA and Affiliates.(applies to all email addresses on this form)Website 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 NomineeAccepted file types: doc, docx, xlsx, xls, pdf, rtf, jpg, png.Please submit files in the following format only: doc, docx, xlsx, xls, pdf, rtf, jpg, pngOr email to custsrv@amtaorg.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 NomineeAccepted file types: doc, docx, xlsx, xls, pdf, rtf, jpg, png.Please submit files in the following format only: doc, docx, xlsx, xls, pdf, rtf, jpg, pngOr email to custsrv@amtaorg.com Comments & CaptchaQuestions/CommentsCAPTCHAPlease enter the letters displayed above to complete your application and then click Submit.