2017 RISING STAR NOMINATION FORMThe ACEC Virginia Rising Star Award, presented by the Next Generation Committee, recognizes employees of member firms who make significant contributions to their company’s success in the Engineering industry. Nominees should meet the following basic criteria:

• 15 years or less of engineering industry experience• Demonstrates leadership in their area of expertise• Involved in professional organizations • Involved in civic and community activities

Equal consideration will be given to member firm employees in all fields (engineering, architecture, human resources, information technology, administrative, etc).

NOMINATION DETAILSNominations are open to any employee of a member firm. In order to be considered, all sections of the attached nomination form must be completed.

AWARD DETAILSNominations will be evaluated by ACEC Virginia’s Next Generation Committee and up to three awards of equal merit will be presented at the 2017 Engineering Excellence Awards Gala at The Jefferson Hotel on February 2, 2017. Nominators will be notified prior to the Gala if their nominee will be recognized and will be encouraged to invite the nominee as a guest of ACEC Virginia for the presentation of their award.

SCHEDULEAll nomination forms must be submitted no later than December 2, 2016.

SUBMISSIONSElectronic submission is preferred. Please e-mail completed nomination forms along with a professional head shot (minimum of 600 DPI) of the nominee to cwhite@acecva.org.

Hard copies of the nomination form may be sent to: Rising Star AwardACEC Virginia8600 Mayland DriveRichmond, VA 23294

Please note that if a hard copy is submitted, a photograph of the nominee must also be e-mailed to cwhite@acecva.org.

QUESTIONSContact Cassie White at cwhite@acecva.org or (804) 447-2171.

2017 RISING STAR NOMINATION FORM

NOMINEE INFORMATION Name: __________________________________________________________________

Title : ___________________________________________________________________

E-mail: ________________________________ Work Phone: ______________________

Employer: _______________________________________________________________

Employer Address: ________________________________________________________

City, State, Zip: ___________________________________________________________

Years of Engineering Industry Experience: ________

EDUCATIONFor biographical use. The following information is not used in the award determination.

School #1: _____________________________________________________________________

Major & Degree: ________________________________________________________________

Year of Graduation: ________________

School #2: _____________________________________________________________________

Major & Degree: ________________________________________________________________

Year of Graduation: ________________

Additional Education & Certifications:

WORK EXPERIENCEPositions Held Within Firm and Description of Leadership Roles:

Trajectory of Career/Previous Positions Held:

Professional Accomplishments:

2017 RISING STAR NOMINATION FORM

2017 RISING STAR NOMINATION FORM

PROFESSIONAL INVOLVEMENTProfessional Organizations and Description of Involvement:

Honors/Recognitions:

How has the Nominee’s involvement with the organization benefited the firm?

CIVIC / COMMUNITY INVOLVEMENTCivic, Philanthropic & Community Service Organizations and Description of Role:

Honors/Recognitions:

NOMINATOR INFORMATION Name: ________________________________________________________________________

Title : _________________________________________________________________________

E-mail: _____________________________________ Work Phone: _______________________

Employer: _____________________________________________________________________

Employer Address: ______________________________________________________________

City, State, Zip: _________________________________________________________________

PHOTOGRAPH Please provide one electronic (minimum 600 DPI) color head shot. Photos should be head and shoulder shots of high quality resolution suitable for publication. Business attire is requested.

RELEASE OF CONSENTI, the undersigned, grant my consent and permission to ACEC Virginia to use my photograph, head shot, other reproductions of my physical likeness and my name as part of the Rising Star Award Program and give permission to ACEC Virginia for the unlimited distribution, advertising, promotion, exhibition of my picture by any method or device. I hereby release and agree to hold harmless ACEC Virginia from any liability, and invasion of any right of privacy or publicity, arising out of the use of my name and photograph. I acknowledge that I have read and understand this Consent and Release prior to signing it. I certify and warrant that I am of legal age and have the full power, right, and authority to enter into this consent and release.

Signature of Nominee: ___________________________________________________________

Print Name: ________________________________________________ Date: ______________

Signature of Nominator: __________________________________________________________

Print Name: ________________________________________________ Date: ______________

2017 RISING STAR NOMINATION FORM